29-331 (2) File # MP- 2010 -0060
APPLICANT /CONTACT PERSON GARCIA LUZ E
ADDRESS/PHONE 276 ACREBROOK DR (413) 582 -9097 Q
W jffl "" tG$I, 331 001 ZQI E UR��100/�
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ONING FO FILLED OUT
Fee Pai
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA - 12 X 18 ADDITION
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 PRESENTED: W "�� (�, l u�Ei - AA/A & we( is
Approved Additional permits required (see below) „ "I' — r
W rlo1-
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
-3 ZS 1d
Signa�tur oe f 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 the Office of
Planning & Development for more information.
111 11
MAR 1 9 2010 D D
File No. fVP
Please type or print all information and return this form to the Building
Inspector's Office with the $15 filing fee (check or money order) payable to the
City ofNorthampton
G 1. Name of Applicant: L y 'Z t! . a 1(' C ( GZ-
Address: _ eibiw Telephone: ���1 � - — 9 0 9 7
2. Owner of Property: L lJ - L ct r C ,
Address: b �-��� b1 1� fir, O W1 1 Q Telephone:
3. Status of Applicant: Owner �« Contract Purchaser Lessee Other (explain)
4. Job Location: L S r4 Q tic,
T
r,
5. Existing Use of Structure /Property:
6. Description of Proposed Use /Work/Project/Occupation: (Use additional sheets if necessary):
Gt hedroo m a r0D17)
lti �Clsaloe aid a c�'�re
7. Attached Plans: Sketch Plan _ i •� Site Plan Engineered /Surveyed Plans
8. Has a Special Permit/Variance /Finding ever been issued for /on the site?
NO DONT KNOW YES IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW YES
IF YES: enter Book Page and /or Document #
9.Does the site contain a brook, body of water or wetlands? NO Y DONT KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , date issued:
(Form continues On Other Side)
W :1Documents\FORMSIorigina118uil ding- Inspector\Zoning- Permit - Application- passive.doc 8/4/2004
10. Do any signs exist on the property? YES NO
IF YES, describe size, type and location:
Are there any proposed changes to or additions of signs intended for the property? YES NO V,
IF YES, describe size, type and location:
11. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common
plan of development that will disturb over 1 acre? YES NO
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
12. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION
This column reserved
p yQ for use by the Building
Department
EXISTING PROPOSED
.' �A 11
Lot Size
Frontage j U "v
Setbacks Front
�
J '
Side L: � � R: i Q L: R:
Rear t fo 3$
Building Height 7
Building Square Footage
(„ % Open Space: (lot area
minus building & paved tt ,
p arkin g
# of Parking Spaces
# of Loading Docks 1 �(
Fill:
(volume & location)
13. Certification: I hereby certify that the information contained herein' true and accurate to the best of
my knowledge.
Date: Ap Si nature
PP 9
NOTE: Issuance of a zoning permit does not relieve an licant's b rden to comply with all zoning
requirements and obtain all required permits from the Boar of Health, Conservation Commission,
Historic and Architectural Boards, Department of Public Works and other applicable permit granting
authorities.
W:\Documents\FORMS\original\Buil ding- Inspector\Zoning- Permit - Application- passive.doc 8/412004
Quick Open Space Calculations Coverages
276 Acrebrook Porch existing
Lot area existing proposed existing
10500 1850 2066 House existing 960
existing 540
Open Space 8650 8434 Driveway existing I 350
total 1850
Open % 82.4% 80.3%
Zone JURA-WSPI Addition , new 216
Req'd 85% Sheds new
Garage. new
total 2066
—NOTE- -
THIS PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER SOURCES AND IS NOT
TO BE CONSTRUED AS AN ACCURATE SURVEY AND IS NOT TO BE RECORDED.
BUILDING LOCATION ACCURACY IS NOT GUARANTEED
NOTE:
SUBJECT TO EASEMENTS AND
RIGHTS OF WAYS OF RECORD.
4 \
105.00'±
I
shed v
BOOK 2381, PAG 167.
PLAN BK. 74, PG 46
t LOT #117 j
o
L — #276
r 2
105.00
ACREBROOK DRIVE
TO: BANK OF AMERICA, N.A. &
LAWYERS TITLE INSURANCE CORPORATION
TO THE BEST OF MY INFORMATION, KNOWLEDGE AND BELIEF
I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING
MONUMENTATION ALL VISIBLE 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 #250167
—NOTE —
SURVEYOR THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
OF — MORTGAGE LOAN INSPECTION PLAT —
.��� "cti NORTHAMPTON, MASSACHUSETTS
RANDALL . �� PREPARED FOR
E.
IZER LUZ E. GARCIA
�
##35032 y SCALE: 1 " =30' FEBRUARY 9, 2010
V HAROLD L. EATON AND ASSOCIATES; INC.
suRV E REGISTERED PROFESSIONAL LAND SURVEYORS
235 RUSSELL STREET — HADLEY — MASSACHUSETTS
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