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SKETCH ADDENDUM
Borrower/Client Kolodzinski
Property Address 26 Golden Drive
City Florence County Hampshire State MA zip Code 01060
Lender Heritage Bank
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Not to Scale
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I hereby report that the premises shown on this plan is not located within a Flood
Hazard Area as shown on Department of H.U.D. Federal Insurance Administration Maps,
Community er 250167 OOOIA
Identifica 'o Da
By:
TO THE HERITAGE-NIS BANK FOR SAVINGS OWNERS
DOROTHY M. AND WILBERT W. DUSHANE
114D THE FIRST AMERICAN TITLE INS. CO.-only 11LOCATIONS
To the best of my knowledge, informa- 26 GOLDEN DRIVE, NORTHAMPTON, MASS.
tion and belief, I hereby report that I ALWR HUNTLEY JR:8k ASS SATES, INQ
have examined the premises -and that this •
inspection plat shows the improvement or SURVEYORS •ENGINEERS•PLANN
improvements as located on the premises .de- 125 PLEASANT STREET P.O. 80X 868
scribed, that the improvement or improve- NORTHAMPTON MASSACHUSETTS 01060
ments are entirely within lot lines, and
that there are no encroachments upon the SCALE'
premises described by the improvement or f
improvements of any adjoining premises, y�p Vlk
except as indicated. I further report that DATE
`a DOUGLAS ,
-there are no easements of record affecting 71. W.
the tract shown hereon, ept as noted. THOtAPSON N q
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THIS PLAT IS FOR IDENTIFICATION PURPOSES ONLY AND DOES NOT CONSTITUTE // PROPERTY SURVEY
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Date Filed- , UJ"" }}`°,, File No.
ZONING PERMIT APPLICATAI q§1`b . 2 )
1 . Name of Applicant: Ii►?'>trC S /�
Address :_,5-C -M&kc,T f� N l} Telephone : i
2 . Owner of Property:,C[) k01j2 721" Ski
Address :01_,/,,-O/rAyYZ.� -Telephone : S"F - y
3 . Status of Applicant : Owner Contract Purchaser
Lessee ys''Other (explain: &141/D-t;kk_. )
4 , Parcel Identification: Zoning Map Sheet# Parcel#
Zoning District (s) (include over Sys) (( .
Street Address
Required
5 . Existinq Proposed -by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
side L -R: L: ad R: t=
- rear '
Lot size
Frontage
Floor Area Ratio
%Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6 . Narrative Description of Proposed Work/Project : (Use additional sheets
if necessary) .�} • ' '' d to 134 O
' 0aizza 90ak FOV& Cl
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7 . Attached Plans : Sketch Plan Site Plan
8 . Certification : I h - y)certify that the information contained herein
is true and ace r e to the best of my knowledge .
Date: �jr��f Z Applicant' s Signature :
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as presented--Reason :
Sp cial' Permit and/or Site Plan Required :
di Requ ' ed. Variance` ], ,equired :
S fiatur uildi s ector_ to
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, Depaitmont of Public Works and other applicable permit granting authorities.
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
a NORTHAMPTON, MASS. ��� - � 19�� Additions �
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location /li/1 Gam/ C, r w,✓ j_ Lot No.
2. Owners name�1D kak,0 Z 1 A)Jk Address_G1/ C7C 10K&) ,C . z /6 rA)G mA
3. Builder's name mT,�� I�/�t 1'p� Address, C !'�'I✓�le�l�-t.��-° J4 'Sh/s� >1'1h� 1744.)
Mass.Construction Supervisor's License No. C70�� � _—Expiration Date
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished? AM ,, 1'3()1" ��C✓�✓—,����' �J �j/� �J�G �[��2uy�'l�
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating 06�7�1 E C4 U l—
11. Distance to lot lines ),
12. Type of roof
13. Siding house __ Z/.I
14. Estimated cost:-42.®J C)d o
The undersigned certifies that the above statements are true to the best of his, her
y� knowledge and belief.
Signature of responsible app,icant
Remarks _.
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