29-366 (4) PERMIT APPLICATION CHECK LIST
PAGE , PLOT ZONE & Gf1 aid YES NO DATE
1 . ZONING FORM APPLICATION
2 . PERMIT I
3 . OWNER OCCUPANT STATEMENT NOT
4 . 3 SETS OF PLANS PLAN
5 . NEW CONSTRUCTION
6 . CURB CUT
7 . WATER S
8 . REMODELING
9 . ADDITION
10 . ACCESSORY STRUCT
11 . SIGN / AWNING
2 . PERMIT FEE - -
1 f '13 . SPECI UI D WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - C R 780
15 . FORM A
16 FILL -
COMMENTS :
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-NOTE-
THIS PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER
SOURCES AND 1S NOT TO BE CONSTRUED AS AN ACCURATE
SURVEY AND IS NOT TO BE RECORDED.
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TO: PEOPLES SAVINGS BANK &
COMMONWEALTH LAND TITLE INSURANCE COMPANY
I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING
MONUMENTATION ALL EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON
THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES,
EXCEPT AS NOTED. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN
A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR
COMMUNITY #
SURVEYOR: Q�^ �• L"A -NOTE-
y--- THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
of -MORTGAGE LOAN INSPECTION PLAT- ,
RANDALL NORTHAMPTON, MASSACHUSETTS
I= PREPARED FOR
135M RODERICK J. & KATHLEEN WESTON
----1'11' - ----- -- - - -- - -
-NOTE-
THIS PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER
SOURCES AND IS NOT TO BE CONSTRUED AS AN ACCURATE
SURVEY AND 1S NOT TO BE RECORDED.
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TO: PEOPLES SAVINGS BANK &
COMMONWEALTH LAND TITLE INSURANCE COMPANY
I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING
MONUMENTATION ALL EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON
THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES,
EXCEPT AS NOTED. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN
A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR
COMMUNITY # a S 9165�
SURVEYOR: �' L"A -NOTE-
low THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
of -MORTGAGE LOAN INSPECTION PLAT- ,
RANEALI NORTHAMPTON, MASSACHUSETTS
IZER PREPARED FOR
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#35= RODERICK J. & KATHLEEN WESTON
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. (�7 �`��P� Alterations
NORTHAMPTON, MASS. 7 l/J `l 19f(/ Additions
APPLICATION FOR PERMIT TO ALTER Repair
,L /d Garage
1. Location 412 !,4AZ (_- - Lot No.
2. Owner's name AoAolei,�}} __ Address /91�J
3. Builder's name ��P. eit/ 4"Lc, t-U.t'JS�• Address
Mass.Construction Supervisor's License No. G/7 7 Expiration Date
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished? A16
8. Repair after the fire
9. Garage/ No.of cars Size
10. Method of heating
11. Distance to lot lines I ee c YN I- q q
12. Type of roof .eL►/7%��
13. Siding house ! /�/c/
14. Estimated cost- 1
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The undersig ed certifies that the above statements true to the best of his, her
knowledg belief
Signature ofrespons a app,icane
Remarks
Date Filed �/`� 1�� File No.
ZONING PERMIT APPLICATION (§i0*.2)
I. Name of Applicant:
Address: Telephone: _ � ®.
2 . Owner of Property: 6 Vle/ ,IL- (t)to S
Address: U �,� �/�, l�/r�.vc c- _Telephone: 5 3
3 . Status of Applicant: Owner G- Contract Purchaser
Lessee Other (explai.n )
4 . Parcel Identification: Zoning Map Sheet# Parcel#3 ,
Zoning District(s) (incl de overlays)
Street Address Requ red
5• Existincr Proposed by Zonin
Use of Structure/Property PLO 5, /P ts,
(if project is only interior work skip to #6) ,r
Building height 3
%B1dg. Coverage (Footprint) 7 7.
Setbacks - front 8
— side L: ' R: L: ef " R: iS
- rear
Lot size o 15 k
Frontage . O e- O
Floor Area Ratio 9&0 O
• %Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6. Narrative Description of Proposed Wo /Pr0 3 t: (Use additional s eets
if necessary) ,1? X p a,, ii O
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7 . Attached Plans: Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained he ein
is true and accurate to the best of my knowled
Date: �/Y4 y Applicant Is Signature:
ZApproved THIS SECTION FOR OFFICIAL USE ONLY as resented p /based on information presented
Denied as presented--Reason: '
S pia ' Permit d/or Site Plan Required:
i g Requi Variance. Required:-/
gnature o u ding Inspect ate
NOTE: Issuance of a zon permit does not relieve an applicant's burden to comply with all zoning requiromonts and obtain all required permits
from tho Board of Health,Consarvation Commission,Dopartmont of Public Works and olhor applicablo permit granting aulhorltlos.
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