17A-139 (3) 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: SOURCE ONE MORTGAGE SERVICES CORPORATION &
FIRST AMERICAN TITLE INSURANCE COMPANY
I HEREBY REPORT THAT 1 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 SHO*I ON FEDERAL FLOOD INSURANCE MAPS FOR
COMMUNITY # 5 n 16 7
'G.�f —NOTE—
SURVEYOR. — — THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
K of -MORTGAGE LOAN INSPECTION PLAT- .
WWOALL NORTHAMPTON, MASSACHUSETTS
L PREPARED FOR
W
f3b032� RUTH S. DUTTON
tl� SCALE: 1 "=50' SEPTEMBER 26,1996
HAROLD L. EATON AND ASSOCIATES, INC.
�. REGISTERED PROFESSIONAL LAND SURVEYORS
235 RUSSELL STREET — HADLEY — MASSACHUSETTS
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Beck. —
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Bath -1. 5'
40 ' cl Dining
Bed R rfI
Room
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JUN - 6 2001
Fi 1 e No. Q i-Ir
DEN OF B BUILDING INSPECTIONS
ERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: �)r \ tv\ C
Address: 2-2—k Telephone: �(P 3 0 2
2. Owner of Property: 1 V✓\ t �( i C ' S
ZZ C -},� __._.
Address: 5� _ Telephone: � 3 ZS� y- 5 30 Z
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain)" j _
4. Job Location: 22` c �b\y� f-" too eyiQ_e
Parcel Id: Zoning Map# Parcel# 13? District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT) G
5. Existing Use of Structure/Property Lo W\,o
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
_T:_4VA 1 2 00 AA 5v use W
7. Attached Plans: X 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 PermitNariance/Finding ever been issued for/on the site?
NO 1 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)
10. ` Do any signs ebst on the property? YES NO X
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 colt to be filled in
by the R=Idiag nepartment
Required
Existin j Proposed By Zoning
Lot size -, 3 � 1/ V" /
Frontage -; .Z (G . Z S 76
Setbacks - frnnt Z'`
- side L:13. 3VR: 13'S , L: 13.3 'R: i
.,.. - rear
Building height
Bldg Square footage
72,7 'Dec k I
%Open Space:
(Lot area minus bldg S
&paved parking)
# of _Parking Spaces
f of Loading Docks
Fill:
vol-ume -& location) (� c1 c,
i
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my Jed,ge.
DATE:- 1206 APPLICANT's SIGNAT
NOTE: Issuanoe f a zoning permit does not relieve Womply Wit"-0
zoning requirements and obtain all required perms f , Conservtati;
Commission, Department of Publio Works and oth apg authorities
FILE #
r
File#MP-2001-0151
APPLICANT/CONTACT PERSON GIPE JAMES W&KIMBERLY HICKS
ADDRESS/PHONE 221 CHESTNUT ST (413)586-3258 Q
PROPE &ATION 221 CHESTNUT ST
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FO FIL OUT
Building Permit Filled out
Fee Paid
T_ypeof Construction: CONSTRUCT FAMILY ROOM ADDITION WITH DECK&STORAGE
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:
App oved as presentedibased on information presented.
enied as p resented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
inding Required under: § Cp.2 'w ONING 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 Board of Health Well Water Potability Board of Health
Permit from Conservation Cow;,�ission Permit from CB Architecture Committee
� o ZOo
Signature of 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.