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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
a I APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location l,G✓�l }� !mil Wx)/ Lot No.
2. Owner's nameI/tr/�� ��°!-� ie'� �t �1 Address &—Lf
3. Builder's name Address L(c S-C�l of 9Q O; S C9�.�L�V'/>9/�S 5
Mass.Construction Supervisor's License No. /7 7 Expiration Date % /7 / 5
4. Addition / CAAi1 (a .92A (d L- ice! )o M C 4 ecZ S17-f-� f P.C✓11116 i2d-1,2
5. Alteration
6. New Porch
7. Is existing building to be demolished? l C�1�e 12- 6 e 126;iw e P
8. Repair after the fire
9. Garage / L X _ No.of cars l Size
10. Method of heating /-/ G
11. Distance to lot lines C`eo 4� / G �- 7� !�r� �C G t �j / �C LOA/2--
12. Type of roof 19 5 j,)h A
13. Siding house
14. Estimated cost:-
The undersigned certifies that the above statements are we to th best of his, her
knowled an�belief.
Signature of responsible appicant
Remarks
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-THIS PLAT NOT FOR RECORDING PURPOSES-
SUBJECT TO AN EASEMENT GRANTED TO
' N.E.T. &T.CO. SEE: BOOK 1399 , PAGE 108
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919 70" L=16 '
WHITE PINE DRIVE
TO: THE HERITAGE BANK FOR SAVINGS &
THE FIRST AMERICAN 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 1- 250167
SURVEYO —NOTE—
THIS PLAT FO MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
��►.�M es k+lr, —MORTGAGE LOAN INSPECTION PLAT—
HARM
L s NORTHAMPTON, MASSACHUSETTS
3 EATON H PREPARED FOR
No.2:- �� SUSAN L. TAVERNIER
pfCISTEa�
IAN�s� SCALE: 1 "=30 ' NOVEMBER 15, 1989
— "� HAROLD L. EATON AND ASSOCIATES, INC.
REGISTERED PROFESSIONAL LAND SURVEYORS
235 RUSSELL STREET — HADLEY — MASSACHUSETTS
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-THIS PLAT NOT FOR RECOR.LINO PURPOSES-
SUBJECT TO AN FAST MF;TiT GRANTED TO
' N.E.T. &T.CO. SEE: BOOK 1399 , PAGE 108 1
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919 7U'
WHITE PINE DRIVE
TO: THE HERITAGE BANK FOR SAVINGS &
THE FIRST AMERICAN 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 # 250167
—NOTE-
SURVEY0147 THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
�tM
OF �C. —MORTGAGE LOAN INSPECTION PLAT-
�rs=� NApLOLD s� NORTHAMPTON, MASSACHUSETTS
3 EATON H PREPARED FOR
No.2:.AI �� SUSAN L. TAVERNIER
�ECISTEa� Qt E: 1 "=30 ' NOVEMBER 15 , 1989
� "�osi SCALE: L. EATON AND ASSOCIATES, INC.
REGISTERED PROFESSIONAL LAND SURVEYORS
235 RUSSELL STREET — HADLEY — MASSACHUSETTS
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'A DEPARTMENT OF BUILDD�G INSPECTIONS
Main Street ' Municipal Building
Northampton, Mass. 01060
WORKER'S COIENSATION MSURANCE t t AVIT
nth a principal place- of busioesslresidcoce at:
�� (surr-t/cit]/st�lrJ�p)
do hereby cerify, under rbe pans and penalties of perjury, Lb'_I,
' oi w ron cove-n employer provid hfll tU v.,or' my
employees worming o❑ this)ob".
(mince Copy) (Policy Number) (Expiration Date)
( eoeral contractor or homeowner (circle one) and have hired
who have the following worker's compensation policies:
(Name of Conlractor) �_nsli.ran�Comp��}/Po�cf Number) (Expiration Datc)
(Name of Contactor) 0nSUf--.0C-- Companyi?o�]cy NUmo°f) (Explm6on Dalc)
(Name of Contractor) (lasuranc Comi /Polic) NuLnL-J) (Fapinaoo Dare)
(Nlamc of Contractor) Compaay/Potic7 Numb�-r) (Expiraoo❑Datc)
(rn i�t,�Gditioml
0ax1 ifacea,ry to c:_.UcSc iaforma�oo pc-.-innr,to to ocdr-won)
(4-�l am a sole proprietor and have no oac wor46ng for rne.
( ) I am a home owner perfor-ruing Al the work myself.
NOTE_plc be awaxV chii wb7 jo bccr zw .t> cmp!of perco'.0 tv +m•xL o¢ pct o0 or repot work of
oct mere th—thaw—ru is V tech the t.^cro: -r re-&Cc co m tS.:Uvuodj zVWjtcnsct d,_cn uc occ ecxn.Uy ooc:ci�-cd to tc
cu player,under tba wvciccr`s cco;Qex_lica Act(G LI 52�1(5) ap?Lin on by bcmcOwMS for]Iictiux ce Pc Ta7d�y cv kx he
legal Mn.of an c=VIoyecuodcrrho Woric.ol,Comgooa.l.iooA t
I u.Zc t.-d tb-xt a .Vy a --y bN f---ded to tbo Dcpu -.mat of lo,!us ai�l ncadrntl Orr oo of Low«boo for c_� `
covcra gc vciific=lino and ths[Galore to cccurc wvcrnbo unc:cr scciioa 25A of 1.S0I.1 S2 an Iczc1 to tbo'icipoafico oCmcua.�!prni!tics
ooasistz>_Zg of♦,lZne of up to S 1,500.00 in the form of S109 Wort Ordrr and
find ocsloo.00..&Y L&LinA.tnc
Mlidbli �y o f 19 9 7 For dw ,,,,o mealy
� P crtnil Number ..
P-5��O
� Maki Lot it
Signature of I iPcxmicicc
0, Do an signs exist on the roe YES NO �
1 Y 9 property?S
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.
Thia col=m to be filled in
by the Bnildiny Department
Required
Existing Proposed By Zoning
Lot size , 0 0 0
f b (( 0 100 cz'z
Frontage ��� 10 61
Setbacks - Q D
- side L:VR:J L: l 6 R:
- rear � 6 t -L'
Building height
Bldg Square footage
%Open Space: l l
(Lot area minus bldg
' &paved parking)
# of -Parking spaces
# of Loading Docks
Fill:
(volume -& location) ,�f A"
13 . Certification: I hereby certify that the information contained erein
is true and accurate to the best of my know edge
_1 rr
DATE: � 7 APPLICANT's SIGNATURE Z
}" NOTE: lasuanoe of a zoning permit does not relieve an a PP iloant's burden to Phwit
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE if
5199"
? File No. i f �, t
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:_ -��,(J / L^ / �2-/��S
ke
Address: Gt�GC f&Aa Telephone:
2. Owner of Property: 4 Y Ud! l /2 �-
Address:_3 &)4t l �'1�t0 Telephone:._ Z
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: A t �e
Parcel Id: Zoning Map# 3K Parcel# �C _ District(s): P--,44A-
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
S. Existing Use of Structure/Property__ to
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
7. Attached Plans: Sketch Plan ✓ Site Plan e/ 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 Permit/Variance/Finding ever been issued for/on the site?
NO ✓ 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_lz— 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
APPLICANT/CONTACT PERSO
ADDRESS/PHONE: X20 E64 ,-3-6 � it) -y i
PROPERTY LOCATION: ¢ _ n
MAP 3 �. PARCEL: ZO
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONTNCI FORM M.T.F.D OUT
Fee Pnid
Bililding Permit Filled niit--
Fee Paid 1-21,32- 0
lRernindelinorTntprinr
Zsz
U
T FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
Approved as presentedfbased 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_
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 Conservati om
Signature of Buil g r Dale/
NOTE: Issuance of n 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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