15B-012 (20) File # 76
APPLICANT/CONTACT PERSON:MANDEVILLE KAREN & SAMUEL ADAMS
582 SPRING ST LEEDS, MA 01053
PROPERTY LOCATION 582 SPRING ST
MAP:LOT 15B-012-001 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Building Permit Filled out
Fee Paid $40.00
Type of Construction: ZPA -ADD UNIT
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
PRESENTED: i F ut.:oe2 Q0 '
ES
Approved Additional permits required(see below) For all projects that need additional reviews 0 -}510
as checked below,please see the Office of Planning& Susta inability Penn it page or scan here - 4 t .
PLANNING BOARD PERMIT REQUIRED UNDER:§ ❑• to;
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 Specia 1 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 Ehri Street Commission Permit DPW Storm Water Management
Demolition Delay
ID- 10-ZO2 Lt
Signature of Building Official Date /f7 1- - 202.4/
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.
y _.. _._ - - __
File No. ? oCj Cj, ft1fi7 Ay ,4 `t
ZONING PERMIT APPLICAT i nR4;1; ' .4)
Please type in this fillable PDF or print and hand-write all info t r c , r turn
to the Building Inspector at the Building Department (212 Main St.) with the • filing fee
by check and money order (payable to the City of Northampton) or credit card (in person only).
1. Name of Applicant: SA M U O z I4 d 00 o Email: SA) /49cJ
Address: --5-2.7 SP-i J"/. r Telephone: 113 -- -s y
2. Owner of Property: i€i i .42n 4,1/.,,' /.)cl's° "'
Address: $ Pi r f .Sf1 4 .vat. 4 t 4,i Telephone:, L,,j- f 1/ - S* P
3. Status of Applicant: Owner E Contract Purchaser ❑ Lessee L_I Other (explain)
4. Job Location
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: /-t 60IL
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
%.e PAti? v7 , / /Poo-/14.- ;3d4 PA 4-"A g,.4
c 7 'P
7. Attached Plans: Sketch Plan Site Plan ❑ Engineered/Surveyed Plans El
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO a DON'T KNOW ❑ YES ❑ IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO El DON'T KNOW ❑ YES El
IF YES: enter Book Page � and/or Document#
]�
9.Does the site contain a brook, body of water or wetlands? NO E I 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)
3/1/2024
10. Do any signs exist on the property? YES El NO C'
IF YES, describe size, type and location:
Are there any proposed changes to or additions of signs intended for the property? YES LJ NO 111
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 will disturb over 1 acre? YES ri 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
Y0 S is LS-4 in-.9
Frontage
Setbacks Front rys� dy p_¢ro a a1
Side L: R: L: R: d L: R:
Rear
Building Height
Building Square Footage
Jo
%Open Space:
(lot area minus building& Pc,-c
paved parking)
#of Parking Spaces
#of Loading Docks
(/GYiI.O
Fill: /Vc1 I /
(volume & location)
Driveway Grade% a/
fAnti ASWn
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge.
Date: ("' a Applicant's Signature ce l -c- -
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,Historical Commission and Architectural
Boards,Department of Public Works and other applicable permit granting authorities.
/ `.
,9 le u w d V 6Gd INITIALS DATE
PREPARED BY
APPROVED BY
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EXECUTIVE` no.15O8
77
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