32C-214 File #56
APPLICANT/CONTACT PERSON:JOHN C LEBHAR BUILDING&RENOVATION
68 SCHOOL ST HATFIELD, MA 01038(413)247-5107
PROPERTY LOCATION 35 HOLYOKE ST
MAP:LOT 32C-214-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $30.00
Type of Construction: CONVERT TO DUPLEX (2 STORY) WITH ADDED 2ND STORY SPACE, DECK
&ADDED EGRESS
New Construction
Non Structural 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
TORMATION PRESENTED:
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 SpecialPermit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW WaterAvailability 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
Demolition Delay
;CIF,
Sid ture of Building 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,Depar•i ent
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 Office of
Planning&Development for more information.
e_C File No.
,' �'- , 0 ING PERMIT APPLICATION (§�10.2)
' _
�1'l10ge ., s e .r print all information and return this form to the Building
Inspector's 0 `ce with the $30 filing fee (check or money order)payable to the
_______9N.PAA olorto City of Northampton
pN �.tq OtOgp Ns •--,
1. Name o pplic„nt: . 0 3 C , L F 5 4 ._ ( Ciwccop--)
Address: 6Z5 5Go/YDI--- #�T /ELaa Telephone: 6/.S) 2z/ —1 !►13
2. Owner of Property: bpi?) Ithf g IfL____ 7,,,,fi- i tr- I-u k�g "J
Address: 3 S+ if 01�7' 6 fr _ 57- N o �T phone: (1 1 , ) �l 23 '-- 8 0
3. Status of Applicant: Owner'� ,` Contract Purchaser Lessee_ Other (explain) (4�,/ A}.L,�✓4-
4. Job Location: 3 S f1.o!.`/d `. ST.
Parcel Id: Zoning Map# SAG Parcel# , LI L District(s):
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: -//"v 4-42 /C.4-"l r ' /Y1) "'_.-(
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
'anJ/tit 1- i7) OUPi6-7- (2_ Sr-o 4,.3 G. %tit .q o pz.o
-52 eo--J2 77-a/-V se'rt-g 1 /9 eG lc 4 �40t12 . ..‘_,
7. Attached Plans: Sketch Plan 1( Site Plan O Engineered/Surveyed Plans
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO ks.. DON'T KNOW YES IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document#
).Does the site contain a brook, body of water or wetlands? NO . IX 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)
emu r' I ; j C I IeVlri 7/ to71
J
W:\Documents\FORMS\original\$uiiding-Inspecinr\Zoning-PermitApplicat ion-pas sive.doc 8/4/2004
10. Do any signs exist on the property? YES NO t,(
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. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common
plan of development that wilt disturb over 1 acre? YES NO )(
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
I ZONING
Lot Size
Frontage
Setbacks Front / -12
Side L: 5-` R: 3 L: R: L: R:
Rear 1-j�- I
6 °�
Building Height
1 — ,5
Building Square Footage
19-- 0. I, 7 0
% Open Space: (lot area
minus building Et paved l9"I aA ( ro
parking I
#of Parking Spaces
# of Loading Docks
Fill:
(volume Et location)
13. Certification: I hereby certify that the information contained herein is true a accurate to the best of
my knowlege.
Date: /7424 Z3" Applicant's Signature y�NOTE:Issuance 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\origiiallBuilding-Inspectorizoning-Permit-Application-passive.doc 8/4i2004