23D-081 (11) � Y
File#MP-2009-0108
APPLICANT/CONTACT PERSON KERSTEN ELAINE RENATE
ADDRESS/PHONE 73 WARNER ST (413)582-0739()
PROPERTY LOCATION 73 WARNER ST
,JVIAP 23D PARCEL 081 001 ZONE URB(100)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM LED OUT
Fee Paid 7✓ —
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA-DEMO ATT SHED&ADD 14 X 25 ADDITION
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PREESF,KtED:
Approved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER: §
Intermediate Project: Site Plan AND/OR Special Permit with Site Plan
Major Project: Site Plan AND/OR Special Permit with Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: § 3 girc,- de c,
Finding L., Special Permit Variance*
O#e TtiftS
Received&Recorded at Registry of Deeds Proof Enclosed O4e- / e keo
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
f .17" 0
Signature of Buildmg Official Date
Note:Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact the Office of
Planning&Development for more information.
----(1-9 1iice{y<
JUN 2 5 2009 'd
File No. /17g0
=ZO IR PEI MITAPPLICATION(§i0.2)
Please type or print-all-information and return this form to the Building
Inspector's Office with the$15 filing fee (check or money order)payable to the
City of Northampton
1. Name of Applicant: E/.51/A'E /-��/?s 7L"c`
Address: .73 4:4--)A7/1 57 /Z.PE#V Telephone: I/13 5-82 673?
2. Owner of Property: C-/. //1-'E
Address: 73 24v99i4 'LA Sf E/pd X,C. /, /V42 Telephone: 'fi3 5 2 C>73 y
3. Status of Applicant: Owner ✓ Contract Purchaser Lessee Other (explain)
4. Job Location: 73 C.1AR, w/P S7` P/c E--As[' 5 fiN,49
Parcel Id: Zoning Map# Parcel# District(s):
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BBUILDING/DEPARTMENT)
5. Existing Use of Structure/Property: J�2 t7/1/ �iy rJi/y
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
Aciile i/C ex 6 fi',vy /3x/33 477;r h ea/sA /e 6 /I ,t/ELv /y x e25 (AtRox)
o ve Sr`oRy R i.74/v.K.f/o f laa/&• weed-) //I/i:1 SP,94&
474 Ih'S do E-,v SuRVE cvrP u 5 f/.9et-E. A9,a ked.-
7. Attached Plans: Sketch Plan Site Plan V Engineered/Surveyed Plans
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW YES ✓ IF YES, date issued: c/-"2 1-—260 3
IF YES: Was the permit recorded at the Registry of Deeds?
NO ✓ DON'T KNOW YES
IF YES: enter Book Page and/or Document#
9.Does the site contain a brook, body of water or wetlands? NO / DONT KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , date issued:
(Form Continues On Other Side)
W:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
10. Do any signs exist on the property? YES NO
IF YES, describe size, type and location:
Are there any proposed changes to or additions of signs intended for the property? YES NO /
IF YES, describe size, type and location:
11. Wilt the construction activity disturb(clearing, grading, excavation, or filling)over 1 acre or is it part of a common
plan of development that will disturb over 1 acre? YES NO i`
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
12. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION
This column reserved
for use by the Building
Department
EXISTING PROPOSED REQUIRED BY
ZONING
Lot Size
7.2 7.2 sg 4* 72 72 ss �t
Frontage ,10 r Err ! rr
56
Setbacks Front / t /i ci 11' LO
Side L:22`64 f R: 3't L: 261611 t R: ( r' L: /,S R: 7_5--
Rear JY 11 IC)7,5
Building Height
.2 .23' 35-1
Building Square Footage /,hv5 653 Shed/6? House Atmi r-,ov
i i ii/ ,f/=2 /05-7
%Open Space: (lot area
minus building& paved a fZ �`7 ' '' '
parking
#of Parking Spaces
#of Loading Docks
Fill:
(volume Ex location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: .Jo -/ Applicant's Signature
NOTE:Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning
requirements and obtain all required permits from the Board of Health,Conservation Commission,
Historic and Architectural Boards,Department of Public Works and other applicable permit granting
authorities.
W:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
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Serrsions
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