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44-132 (5) File #22 "©t K APPLICANT/CONTACT PERSON:DOUGLAS E GOODNOW 31 Campus Plaza Rd HADLEY,MA 01035 PROPERTY LOCATION 474 EASTHAMPTON RD MAP:LOT 44-132-001 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: ZPA -CREATE 2ND FLOOR BREAK ROOM WITH SHOWER New Construction Non Structural Renovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans/Plot Plan Driveway Grade% THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENT D: Approved Additional permits required(see below) For all projects that need additional reviews ■ iN-}Fg^ ■ as checked below,please see the Office of Planning& Sustainability Permit page or scan here - ' 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: § Finding Special Permit Variance* Received&Recorded at Registry of Deeds Proof Enclosed 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 Demolition Delay //7/2 S-21- Z 20 `1 Signature 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,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 Office of Planning& Development for more information. --.:. File No. do? C'/lid 30% ' <30 24 ZONING PERMIT APPLICATION (350.4.4) Please type in this fitlable PDF or print and hand-write all information and return to the Building Inspector at the Building Department (212 Main St.) with the $30 filing fee by check and money order (payable to the City of Northampton) or credit card (in person only). 1. Name of Applicant: j)U /,, , Email: A C 5- WQ Address: LI S-tvi-2t4) � �a �l�M5� �� M4 Dio0?Telephone: 1(13 -511 c I 2. Owner of Property: ' UV t 15c,/1 Address: l 14 ee f -rA a4n p 0t �'�' Telephone: l &9- 3. Status of Applicant: Owner I 1 Contract Purchaser I I Lessee Other (explain) C one/6-C71)� 4. Job Location: J/ fS' n Z. A 1476 L 7"1 ja-Sf/u4.p76, rL0 Nor1'A"t o/t Parcel Id: Zoning Map# Parcel# District(s): In Elm Street District In Central Business District (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property: £ki'S e'-e-1 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): C a 1 6oth fLe, /k, 5 Ca f 4 ar(vt, £ t4hr 0.0'.. /L. ,Cfs 7. Attached Plans: Sketch Plan P7 Site Plan ❑ Engineered/Surveyed Plans ❑ 8. Has a Spec'.l Permit/Variance/Finding ever been issued for/on a site? m% NO ►s/. DONT KNOW YES IF YES, date issued: IF YES: Was the permit recorded gistry of Deeds NO L__I DONT KNO YES iii&___ 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) 6/7/2023 Et/ 10. Do any signs exist on the property? YES NO I I IF YES, describe size, type and location: LA/115,9r, piii,41A6) 1 5 Are there any proposed changes to or additions of signs intended for the property? YES Ell NO El IF YES, describe size, type and location: 11. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 cre or is it part of a common I plan of development that will disturb over 1 acre? YES I 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 Dept.only. EXISTING PROPOSED REQUIRED BY ZONING Lot Size Frontage Setbacks Front Side L: R: L: R: L: R: Rear Building Height Building Square Footage %Open Space: (lot area minus building a paved parking) #of Parking Spaces #of Loading Docks Fill: (volume & location) Driveway Grade% I 13. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. Date: 3 I ` Applicant's Signature NOTE:Issuance of a zoning permit does not relieve an pplican s burden to comply with all zoning requirements and obtain all required permits from the Board of Health,Conservation Commission,Historical Commission and Architectural Boards,Department of Public Works and other applicable permit granting authorities. 6/7/2023 . ,. - P IAA ___, v!PI i i F ---S 2 , 1 . , ' Q , . , t , ..... ____ . .„, , 1 r 'Sin lc ye pkr-s r6' V i'QINU- C4410;r4-1. f ' \ 1 j ( 2 Or (147) , Ven - i r e, kla , ,50(----(-4 IA P21 4/Lei - 6 lo d)i? all fp 4 /11 ( --9-* 1) k K -f-77( , r1S, L4 , i \k I /,_ 5kaarati<- 1 , \ I a_ i7,4( A i rl 6 i . , 1-119 Eet, YriN4atitetoA Ph : p Dr-t k it Ay 1°"A 1 th It - , m e `i C b C ' O R W irljC C ^h N la in -a F i U, J Wz =m FV-736il1224 I I v p ► W3018 W1830L I DID I W1830R p 1D1 1 3o C o L Q �. 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