24B_038SS 327 King St Zoning Permit AppL s
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__ File No.,/~~ ~ ~ 3
~ `'. ' ~ . "`~' ` ` ~~J~ING, PERMIT APPLICA TION (~10 2) ~`
Please type or,-paint X11 information and return this form to the Building
Ins ' ector's .Office::with the $Y5 ding fee (check or more order a able to the
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City ofNorthampton
1. Name of Applicant: P~~~,~.~- ~.-~`rnU ~\~~U ~ C~ p ~~~~- `~/~ `Y~~SS
a-~ ~ ~ osol~ ~D3 -X21-!'~ 1 ~
Address: L ,V ~-S~y ~ ~ Telephone:
2. Owner of Property: ~~'«~Q-Nl ~~t~~-
Address: ~ ~ lD ~~ 1 ~~hrn ~t-t-Y'~ ~ ~S~U~ i ~ Telephone:
3. Status of Applicant: Owner Contraact Purchaser Lessee Other (explain) ~ G rat"
4. Job Location: ~~~ ~~V~4~ ~'1'Y~e~ V-
Parcel Id:' Zoning Map# Parcel# District(s): -
In Elm Street District ` In Central Business District -
(1"0 BE FILLED,IN BY THE BUILDfNG DEPARTMENT) `
5. Existing Use of Structure/Property: 1.~~ ~~~
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7. Attached Plans: Sketch Plan Site Plan ~() 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:
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 ~ DON'T KNOW _
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained
Obtained ,date issued:
YES
(Form Continues On Other Side)
W:\Documents\FO[tb(5\original\Building-Inspector\Zoning-Permit-Application-passive.doc 3/4/200~F
Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
.,
10. Do any signs exist on the property?
IF YES, describe size, type and location
YES
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NO
Are there any proposed changes to or additions of signs intended for the property?
IF YES, describe size, type and location
YES N0~
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 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 INFO Th9s column reserved
for use by the Building
T1nn~rtmont
Lot Size
Frontage
Setbacks Front
Side
Rear
Building Height
Building Square Footage
Open Space: (lot area
minus building & paved
parking
# of Parking Spaces
# of Loading Docks
Fill:
(volume & location)
EXISTING PROPOSED REQUIRED BY
ZUMNG
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13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: ~• ~ ~ U 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 dVorks and other applicable permit granting
authorities.
4
3/4/2004
W : Documents\F02i~lS\original\Building-Inspector~Zon ing-Permit-Application-passive.doc