10D-027 (7) File #90
APPLICANT/CONTACT PERSON:COLLINS, CHRISTOPHER
162 MAIN ST LEEDS, MA 01053
PROPERTY LOCATION 162 MAIN ST
MAP:LOT 10D-027-001 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 -12X10 ADDITION
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:
Approved Additional permits required(see below) For all projects that need additional reviews ( f o
as checked below,please see the Office of Planning& Susta inability Permit pageor 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
f/& i Z- y.ZDZN
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.
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File No.
i
ZONING PERMIT APPLICATION(35(1.4.4)
Please type in this f liable PDF or print and hand-write all information and return to
the Building Inspector at the Building Department (212 Main St.) with the $40 filing fee by
check and money or er(payable to the City of Northampton))or credit card (in per,.s/on.only).
1. Name of Applicant: l h t 4S4-Ci'i�.r COI 11 i l7 Email:CI tt-YO/j jy s' 6 7 )f ,(oft"
Address: It‘22 Mei iv\ 1- 1.-QQ,rf) iv\A O S3 Telephone: 3 n ai 1b[
2. Owner of Property:(j'�r 1�) Colr Telephone:
3. Status of Applicant: Owner Contract Purchaser❑ Lessee 0 Other❑Explain:
4. Job Locations. 10- I N1. SF 1-4/i n lG
Parcel Irk Zoning Map# Parcae WWII)j D trict(s):
in Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT) I _
5. Existing Use of Structure/Property: 'cg1n\Ct.,( IA'5W)ti. "-C(V,:I�1 1'thi'
6. Description of Proposed Use/Work/Project/Occupation(Used Addidonat Sheets if necessary):r
rNr 1Z-rto Q no,I,ov‘ accc .odal- n /16i ( c1
yteto k 1„
7. Attached Plans: Sketch Plan❑ Site Plan:El Engineered/Surveyed Plans❑
8. Has a Special Permit/Variance/Finding ever been issued for/on the site? No❑ Don't know® Yes❑ If Yes,
date issued Was the permit recorded at the Registry of Deeds? No 0 Don't know 51 Yes
If Yes,enter Book Page Document#
9. Does the site contain a brook,body of water or wetlands? No❑ Don't Know❑ Yes 'If yes,has a permit been
or need to be obtained from the Conservation Commission? Needs to be obtained❑ Obtained❑
Date:
10. How many trees will be removed? () At 4 ft.above ground level,how many of the removed trees are 5"in
diameter or greater
11. Do any signs exist on the property? N. im Yes If Yes,describe size, type and location:.___ _
Are there any proposed changes to or additions of signs intended for the property? 14o4Yes If Yes, describe
size, type and location:__
12. Will the construction activity(clearing,grading, excavation or fillin )disturb over 1 acre, or is it part of a common
plan of development that will disturb over 1 acre? Na Yes If Yes, then a Northampton Stormwater
Management Permit from the DPW is required.
13.ALL INFORMATION MUST BE COMPLETED, OR PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION
This column reserved/or use
by the Building Dept.only
EXISTING PROPOSED REQUIRED Al'
` ZONING —
Lot Size �� r t(21 it W2 fC 5/C'OC
Frontage w
3)ci -3704-f Joe
Setbacks Front S-r)
Side L: R: L: R: L: R
Rear f
Building Height c�L f ' Ir L I
Building Square Footage
Il(r)C
%Open Space: Cy
(lot area minus building a a
paved parking)
,a of Parking Spaces
#of Loading Docks
Fill:
(volume£t location)
Driveway Grade% �.; _' * _ ',
14. Certification:I hereby certify that the Information contained herein is true and accurate to the best of my knowledge.
n
Date: !/ !71.~ Applicant's Signature `
NOTE:Issuance of a zoning permit does not relieve an a icant's burden to comply with all zoning requirements and
obtain all required permits from the Board of Health,Conservation Commission,Ilisioriral Commission and Architectural
Boards,Department of Public Works and other applicable permit granting authorities.