69 Paradise Rd demo 2013-06-06_REC EIVED
IN 32013 ` I File No. P - 13 - 1d
PE NG PERMIT APPLICATION ( §I 0.
ease a or print all information and return this form to the Building
Inspector's Office with the $15 filing fee (check or money order) payable to the
City of Northampton
1. Name of Applicant:
`
Address: �- Q l� �l �""`t Noc Telephone: x/13 - � " Z 3 7 y
v
2. Owner of Property:°��
Address: ' Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee 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* ° i c ,
6. Description of Proposed Use /Work /Project /Occupation: (Use additional sheets if necessary):
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 DONT KNOW A 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 1�_ 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 issued:
(Form Continues On Other Side)
W: \Documcnts \FORMS\ original \Building- inspector\Zoning- Permit - Application- passive.doc 8/4/2004
10. Do any signs exist on the property?
IF YES, describe size, type and location:
YES NO
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 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 INFORMATION
This column reserved
for use by the Building
Denartment
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: 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 Worlcs and other applicable permit granting
authorities.
W \ Documents\ FORMS\ origins]\Building- Inspeetor%Zon ing- Permit- App]i cal ion- passive.doe 8/412004
EXISTING
PROPOSED
REQUIRED BY
ZONING
Lot Size
Frontage
Setbacks Front
Side
Rear
L: R:
L: R:
-
L: R:
Building Height
Building Square Footage
Open Space: (lot area
minus building Et paved
parking
# of Parking Spaces
# of Loading Docks
Fill:
(volume Et location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: 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 Worlcs and other applicable permit granting
authorities.
W \ Documents\ FORMS\ origins]\Building- Inspeetor%Zon ing- Permit- App]i cal ion- passive.doe 8/412004
File # MP- 2013 -0124
APPLICANT /CONTACT PERSON SMITH COLLEGE C/O FACILITIES MGMT
ADDRESS/PHONE 126 West Street (413) 585 -2374 ()
PROPERTY LOCATION 69 PARADISE RD - MASON HALL INFIRMARY
MAP 31C PARCEL 013 001 ZONE EU(123)/RR(86)/WP(86)/iJRC (38)/FFR(1)/
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA - DEMOLITION
New Construction
Non Structural interior 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
INFORMATION PRE�dditional e
Approved 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 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: !'– Pe" �e' ;' "
Curb Cut from DPW
Septic Approval Board of Health
Water Availability Sewer Availability
Permit from Conservation Commission
Permit from Elm Street Commission
Permit from CB Architecture Committee
Permit DPW Storm Water Management
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.
Well Water Potability Board of Health
* Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact the Office of
Planning & Development for more information.