29-224 (3) 'MORTGAGE LOAN INSPECTION
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I hereby report that the premises shown on this plan is not located within a Flood
rd Area as shown on Department of H.U.D. Federal Insurance Administration Maps,
Community Nu er 250167 OOOlA
Identificati D to April
By: �--
FLORENCE SAVINGS BANK OWNERS
ESTATE OF MARY F. O'BRIEN
FIRST AMERICAN TITLE INS. CO.-ONLY LOCATION=
the best of my knowledge , informa- 136 ACREBROOK DRIVE FLORENCE
A belief, I hereby report that I - ALMER HUNTLE
;ami ned the premises -and that this Y,JR. Ek ASSOCIATE% INC
;ion plat shows the improvement or SURVEYORS - ENGINEERS - LANDSCAPE ARCHIT CTS-
!ments as located on the premises de- 30 INDUSTRIAL DRIVE EAST P.O. BOX568
I, tha the improvement or improve- NORTHAMPTON, MASSACHUSETTS 01060.
ire en irely within lot lines , and
sere a no encroachments upon the SCALE,
described by the improvement or
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Z�" cl z L 3 Alterations
NORTHAMPTON, MASS. /c��Q 191 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location Lot No.
2. Owner's name ko<;,,/,(" Address
3. Builder's name L c) ci,S Address 40 7")."
Mass.Construction Supervisor's License No. el r3Y Ae/iy�y"Z- Expiration Date
r r r
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished? /V
8. Repair after the fire ry '
9. arage i y No.of cars Size
10. shod of heating K c t c/ /fo✓' ���TrL.
11. Atance to lot lines ivera Z/-/ rj r W r /%' ,Ys T,•� )�u,r 4 l' Se, /H - i� eX
12. Type of roof A 6 f-SL!�la-ss do,)F J'd, Ie
13. Siding house / 0 r ra J• 7_so Vr rr
14.)Estimated cost:-
The undersigned certifies that the abovc.statements are true to the best of his, her
knowledge and belief.
71 —slgllalur of onsible app icani
1
Remarks �'j' C J-
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
IF YES, describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This co.1— to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage Cc Y- y 3
Setbacks - frnnt T 3 CJ
- side L: �% R: 5 L: 3 R: lS _
- rear f� x
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg — ' sC, ,
' &paved parking)
# -pf. Parking spaces
f of Loading Docks
Fill:
Avol-time--& location)
13 . Certification: I hereby certify that the information contained herein
_. is true and accurate to the best of my knowledge.
a
DAVE: APPLICANT's SIGNATURE
NOTE: Issu noe o a zoning permit does not relieve an appli Ys burden to comply witt�,,.$ll
zoning requirements and obtain all required permits from Board of Health, Conservation
commission, Department of Publio Works and other applicable permit granting authorities.-
?';, FILE #
t
File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: zuv�'�
Address: Telephone: Z "? - �' -j7
2. Owner of Property: �� j
Address: Telephone: 1 Y-3 7
3. Status of Applicant: Owner Contract Purchaser Lessee
t-- Other(explain): 75-
4. Job Location: S '4 C _c< /C �>c
Parcel Id: Zoning Map#_T Parcel# District(s): -G� -& �
(TO BE FILLED IN BY THE BUIL15ING DEPARTMENT)
5. Existing Use of Structure/Property /"-/c)-,1
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
7. Attached Plans: Sketch Plan Site Plan '� Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special �Jermit/Variance/Finding ever been issued for/on the site?
NO 'il 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 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)
FILE if " 0 ANj�
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE: S �z
PROPERTY LOCATION:
MAP PARCEL: ZONE tz:�z G✓ �
THIS SECTION FOR-OFFICIAL USE ONLY:
PERNUT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATY
Fee PAid L
lRiii1din2 Permit Filled nut
New (nnstrnrtinn
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THE LLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
t A HI
Approved as presented/based on information presented
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under:§ w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
I/
Variance Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
Permit from Conservatio mmissio
g
Signature of Building for Date
NOTE:Wauanoe 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, Department of Public Works and other applicable permit granting authorities.
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