35-135 (5) 20 WESTWOOD TER BP-2019-1305
GIs#: COMMONWEALTH OF MASSACHUSETTS
Man:Block:35- 135 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Catceorv: Deck BUILDING PERMIT
Permit# BP-2019-1305
Project# JS-2019-002105
Est.Cost:$9500.00
I'm $65.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: JONATHAN SOUTRA 112307
Lot Size(su. h.): 9888.12 Owner: SULLIVAN DEBORAH
zonimi: Applicant: JONATHAN SOUTRA
AT. 20 WESTWOOD TER
Applicant Address: Phone: Insurance:
46 SOUTH ST (413)977-3212 WC
SOUTH HADLEYMA01075 ISSUED ON.512412019 0.00:00
TO PERFORM THE FOLLOWING WORK:BUILD GROUND LEVEL DECK AND PUT IN NEW
DOORWAY IN PLACE OF WINDOW *DECK APPROVED BASED ON SUPPLIED PLOT PLAN
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oill. Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occuoancv Signature:
FeeTvpe: Date Paid: Amount:
Building 5/2420190:00:00 565.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck-Building Commissioner
File#BP-2019-1305 ,�gy�pp
APPLICANT/CONTACT PERSON JONA"JAN SOUTI LL1{I,11
ADDRESS/PHONE46 SOUTH ST SOI 'HHADLEN (413)977.3212 it's
PROPERTY LOCATION 20 WESTWOOD TER 6.1
MAP 35 PARCEL 135 001 ZONE
THIS SE(TION FOR OFFICIAL USE ONLY:
PERK T APPLICATION Cfff1KLIST
NC ED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled our
Fee Paid
Typeof Construction: BUI D UND LEVEL DECK PUT W PLACE OF
WrN W R9v s ouA PTAPIA
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/Statement or License 112307
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
IN RMATION PRESENTED:
_Approved_Additional permits required(sae below)
PLANNING BOARD PERMIT REQUIRED UNDER:$
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: g
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 Hgahh 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
Demolition Delay
64- ' X// nn
s- z
Signature of Building O73iciar Date
Note: Issuance ofa 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 Office of
Planning&Development for more infomtation-
Deparbnent use only
City of Northam s o erm
.,> Building Depa aro c Permit
212 Main Str MAY 1 6 r A dNy
Room 100 Water IA
phone 413-587-124011 Fax 13,.W Bwr;i s TI.N ml Plans
oN
er Specify
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAINLY DWELLING
SECTION 1 -SITE INFORIWTMN
1.1 Property Address This section to be eomPNtatl by office
ac (1IES -lar-
Twoors Mi Lot I 5 Unu
(Lp2eoJCG r t�R of O(a— Inss OverlayDismet
6m IR.Disk4d Ce Dbbtct
SECTION 2-PROPERTY OWIERSIW/AUTHORRED AGENT
21 Owner of Recwd:
��6FSOrc-A r{ A - SJL.LrJIs� SAWSG
Name(Rtt6 �, -- Conant- igAOnsaa. k3o1-�
Telephone
SiPresee
u Authorized Ageelt /4 ercc Kznndge Rd. Hadky A%A, 01039'
SLA okKo.n .SOykm
Name(Print) Cu eot Me"Miasma:
Qu4�6. A q13 -177-3a1�
Telephone
SECTION 3-ESTNMTED CONSTRUCTION COSTS
Item Esti wiled Cost(DOOM)to be Official Use Only
I. Building $ Sold (a)Building Pat Fee
2. Eleclncal (b)Esbrditd Total Cost of
ConStRiC ion f om 6
3. Plumbing Builds"Pannit Fee
4. Mechanical(HVAC)
5.Fre Protection
6. Total=(1 +2+3+4+5) Chad,W.A.
This Bacton For Official Use Only
Building Permit Nuaber. Date
Issued:
Signahme:
Brrlaig Canme:6lwBNpperlar W Bwkeys Dale
Short-A tannic Trap t-t - Com
EMAIL ADDRESS(REQUIRED; EITHER HOMEOWNER OR CONTRACTOR)
1 ,��
Section 1. ZONING •II Information INut Be Complmd0 Permit Can Be Dented Due To Irconplete IMonnatfon
Existing Proposed Required by Zoning
This Manan w h find in by
Building Dcymtmmt
Lot Sim
Frontage
Setbacks Front
Side U R: U R:
Rear
Building Height
Bldg.Square Footage %
Open Space Footage X
(W m.min.bldg a pwad
#of Puking Spaces
Fill:
volwrcd Ia.tion
A. Has a Special PermR/Variance/Findin been issued for/on the site?
NO O DONT KNOW YES O
IF YES, date issued:
IF YES: Was the permit recorded at the!egiplry of Deeds?
NO O DONT KNOW YES O
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of Water or wettandO NO d DONT KNOW O YES O
IF YES, has a permit been or nerd to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO V
IF YES,describe site,type and location:
D. Are there any proposed changes to oradditio s of signs intended for the property? YES O NO
IF YES,describe size,type and location:
E. Will the construction activity disturb(clearing,grading,so valion,or filing)over i am or is it part of a common plan
that Wil disturb overt acre? YES O NO
IF YES,then a Northampton Storm Water Management Permit from the DPW is required.
E DESCRIPTION OF PR all anialikablai
New House Addition E] antO ndows 8) Roofing
or Q
Accessory Bldg. O Demolition N.Signs [EM Dscat Slang[oj Ottw[Cq
Brief Description of Proposed
Work. *16sb d 1C.4a rtiuo dco' W clarJ
Alteration of mashing bedroom_Yee_No Adding new,bedroom Year No /
Attached Narrative RenovaMg unfinished basement Yes ✓ No
Plans Attached Roll -Sheet
a.ff New house and o7 addition to existina housing, complete the following
a. Use of building.One Family Two Family Other
It. Number of rooms in each family unit: 3 Number of Bathmoms
c. Is there a garage attached? N"
d. Proposed Square footage of new constmclion. Dimensions
a. Number of stones?
f. Method of healing? Fireplaces or Woodsloves Number of each
g. Energy Conserve ion Compliance. Masscneck Energy Compliance form attached?
h. Type of construction
I. Is construction within 100 ft.of wetlands? Yes No Is construction within 1 W yr. floodplain_Yes_No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No.
1. Septic Tank_ City Sewer Private well City water Supply
SECTION 72-OWNER AUINORQATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLES FOR BOLDING PERMIT
1, r- Jl'-r—"O2Ni{ 1L S,,L.f...�a�J as Owner of the subject
property
hereby auUome 73/, >C t'rAn SDIIl ra
to act onply behalf i all Iters relative M work auMatrad by Mrs building perms application.
u _
fillmobse,0 Owrwf Date
I, 10 nafha� sc,'A l _as OwnsdAUMarltad
Agent hereby declare that the statemerts and mbmalon on Me foregoing application am true and accurate,to the best of my knowledge
and belief.
Sign
Signed under the pains and penalties of perjury
T .
\`Orv0.�'hnti
Prim Name � L
Q..t�D -4 . S114 AO I1
Signatuall of OwnedAgwa Delle
SECTION a-CONSTRUCTION sERWCES
&LIMrind Construction Supervisor: Not Appficahle ❑
tWraMUuw Nolehr: 'Son::li.avt SnJ{RY. C$ -tla 307
Cicero¢Nurali
410 %,)tt, kWAW4 rocT, 010-7S 11--)L l
Adder FipiraUon Date
Q srdG`� A . WS-977-3dt�
511 aff Tekpmm
9.Realgliand 11111111111111110 bMDMVBWAUtCagdlbtbBr. Not Applioable ❑
Sant'c-q �9I $D3
Commnv Nam Registration Number
so +m fA ,,,c T-mpt-o vcmtrr� s/t4/ aD
Address Expiration Date
9b s,o+ Sit, QOA-I, ND,dky MA,DID�elepinrre 4r3 g91'3�a-
SECTION 10-VVOFKERV COMENSATION IN URANCE AFFIDAWf Ir.c.1-r:.Is s meq"
Workers Compensation Insurance affidavit must be completed and submitted with this appk abDn. Failure to provide the atfidava vdll rasutt
in Ute denal of the issuance of the
SWWAMavdAftdwd Yes....... No...... O
City of Northampton
( Haasachusetts
l_A o s
1' ( 122 t 8 tff'8rrr.Ui9G l Dallldo S 2
xvz Wfn Bta�e . �•. ' ani]G(nq i
Ibctbvptm, Mi +oa06o �aC
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
The Office of Consumer Affairs and Business Regulation("OCABR")regulates the registration of contractors and
subcontractors performing improvements or renovations on detached one to four family homes.Prior to
performing work on such homes,a contractor most be registered as a Home Improvement Contractor("HIC").
M.G.L.Chapter 142A requires that the"reconsotwOon, allocation,renovation, repair,modernization, conversion,
improvement. removal,demolition, orconsrmcbon or an addition to any praexishng owoero pied building containing
at least are but not more than lour dwelling urils.._orto stmctures which are adjacent to such residance or building'be
done by rettistered contractors.
Note:If the homeowner has contracted with a cotporadon or LLC,that enter most be registered
Type of Work: j)CX_k, Est.Cost: t`A Ism _
Address of Work: Q D LVc,S+VJ0Z)4 -1 enw-f-, F1rx+r`CC 41A. o(O6A
Date of Permit Application: VISI 11
1 hereby certify,that:
Registration is not required for the following reason(s):
_Work excluded by law(explain):
_Job under$1,000.00
_Owner obtaining own permit(explain):
_Building not owner-occupied
Other(specify):
OWNERS OBTAINING THEIR OWN PERMIT OR ENTERING INTO CONTRACTS WITH UNREGISTERED
CONTRACTORS OR SUBCONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK ARE NOT
ELIGIBLE FOR AND DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND
UNDER M.G.L.Chapter 142A.SUCH OWNERS ALSO ASSUME THE RESPONSIBILITES FOR ALL WORK
PERFORMED UNDER THE BUILDING PERMIT.SEE NEXT PACE FOR MORE INFORMATION.
Signed under the penalties of perjury:
I hereby apply for a building permit as the agent of the owner:
57/sUR 70natt-AA Sodi-2 191 go3
Date Contractor Name HIC Registration No.
OR:
Notwithstanding the above notice,I hereby apply for a building permit as the owner of the above property:
Date Owner Name and Signature
City of Northampton
Massachusetts '.
LFTMRfffirf OF Bf/rLIJ XS WTr=S ,t
212 win s[x'eet ,mp;aipal HYS1EiOq ��
\" xortna.prao, to 01060 r,,. V),�
Massachusetts Residential Building Code
Section 110.R5.1.2
Homeowner: Person(s)who own a parcel of land on which he/she resides or intends to reside,
on which there is,or is intended to be,a one or two family dwelling,attached or detached
structures accessory to such use and/or farm structures. A person who constructs more than one
home in a two-year period shall not be considered a homeowner.
Section 110.85.1.3.1
Any homeowner performing work for which a building permit is required shall be exempt from
the licensing provisions of 780 CMR 110.R5,provided that if a homeowner engages a person(s)
for hire to do such work,then such homeowner shall act as supervisor.
Such homeowner shall submit to the Building Official,on a form acceptable to the Building
Official,that he/she shall be responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the job site will be required from time to
time,during and upon completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152 (Workers' Compensation)and Chapter 153
(Liability of Employers to Employees for injuries not resulting in Death)of the Massachusetts
General Laws Annotated,you may be liable for person(s) you hire to perform work for you
under this permit
City of Northampton
S S�
•9/ Ma88achl ttz
IJT� OF BUIZOIbG ZASPBLTIQ85 -
212 M 8 •M 'i Ps S"Jl � -
xorth ryG , M 01060
Debris Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as a condition of the building
permit all debris resulting from the construction activity governed by this Building Permit shall be disposed
of in a properly licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
The debris from construction work being performed at:
a,o UA�+"u7ood 96-Cna 1141A. b106a'
(Please print house number and street name)
Is to be disposed of at:
VW ,�-"'I Ci11Y19
(Please Drill name tl location or facility)
Or will be disposed of in a dumpster onsite rented or leased from:
(Company Name and Address)
Signatu of Permk Applicant or Owner Date
If,for any reason, the debris will not be disposed of as indicated, the Applicant or Owner shall notify the
Building Department as to the location where the debris will be disposed.
The Commonwealth of Massachusetts'
Department of Industrial Accidents
1 Congress Street,Suite 100
r Boston,MA 02114-2017
-ii www.massgov/dia
Workers'Compensation Insurance Affidavit:Banders/Cmtraelors/Eleetrkians/Plumbers.
10 BE FILED WITH THE PERMITTING AU I HORI I'I.
AnolTcant Information Plume Print Leeibly
Name(Bassitle /oreaticitioNmdividuap: St,,)j= pigQM-Ars 9OL"
r
Address: %- SDLJ+- ' S4,
city/State/Zip: -%a M . Ol D7S Phone#: YiZ -977-Sal-L-
Ateyaa su mploter±Chera tarappraFrlate hos: of m (required):
Type P 1eet(n9 ):
I.�I acm,pl�wer u;W maao,en(lost atwwlon-time)• 7. []New construction
2 Ima.ole pmpricmr or punmhipad h�vem mpmYm warkmg fwmem g, []Remodeling
as,wvrm Noxmkers'camp.iwuaMc nvlmrN.�
301 aur a homamma dmng an wort mywit [No wmk,.swas uavmcerequ,ree l' 9. []Demolition
a.[]lama la,mm—and w,n i.,-h... amuratwsmcatlwa Nl wwtmmy ptepetr. Icon 10 Building addition
wvmemw:dleommal. oh,11a'assons'mmpntwim emmac um sok I I.[]Electrical repairs or additions
popx'mn withma cmg—
12.[]Plumbing repairs or additions
5[]1---al conyver mat t fin-had nc ml.w-mmws lnun as tic arad,let 13CRoofrepaus
'rltme subummnas ha.e emptgas N art werkm'canT.irwaarre.: a,te-,(/
6.[]Wemacmpotmwn andira atiiun Mv<eaemiud Wen dgM of exn�tim pa MGL c. 14.uOder o(G�
153,41(a),and we have m employs.INo wwkms'casq_imusrae reauad.l
•Any applicmtthat checks bon ilI most also fill out the sivoms below slowing then workers'consassualum polis,information
'Bmmwton who submit Jiffs amdevit malicsting Jit',are doing all amok all two(tire made comm mos must submit a new affidavit indkating oah
:Contmcmrs Jot check this bon own inched an additional sM1 y showing the reme offlcwbcanmmars and smk whadia moot thou minks have
employ— Ifthe sul,csasmemrs M1ave emplo,,,ti,they most provide Wen woders comp.puha,namhr.
I am an employer that is providing worNers'compensation insurance for my employees. Below is the poliy andjob sae
Information. p�
Insurance Company Name: gCai Hodson _
Policy#or Self-ins.Li;.#: L Ab iD0 S$Tea? —C) Expiration Dahc_VV4
Job Site Address: .20 aX-S4-VXa'sd. Ten4GC.. City/StaWZip: . Fhdlel hlA. O101S
ARac6•copy of the worken'compensation polky declaration page(showing The policy number and expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00
and/or one-year imprisonment,as well as civil penalties in the farm of a STOP WORK ORDER and a fine of up to$250.00 a
day against the violator.A copy of this statement may be forwarded to the(ice of Investigations of the DIA for insurance
coverage verification.
I do hereby c/eer��tify under are pains and penall fie,of perjury that the infornnBon provided above is one and correct
Simulate V7/aL� A , kzff �" Date 6719V2
Phone 0: $-S - 777—'&AP-
OJj7chrl use only. Do nal write in this arm,to be completed by city or town ogrci st
('ity or Town: Permil/Licrose,g
I situ ing Authority(circle nae):
I. (bard of Hest 2.Building Depardet 1 CWyfromm Clerk d.Electrical Inspector 5.Plumbing Inspector
b.Other
Contact Person: Phone M:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers m provide workers'compensation Inc their employees.
Pursuant m this stance,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,met or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in ajoint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee ofan individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction Or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(6)also stales that"every stale or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Pleam fill urn the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contracton g camels),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability partnerships(LLP)with no employees other than the
members or paMers,are not required to carry workers'compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance covemge. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,nM the Department of
Industrial Accidents. Should you have any questions regarding the law or if you art required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be some that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sate m fill in the pemiit/license number which will be used as a reference number. In addition,an applicant
that muss submit multiple pennidlicense applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in_(city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled can each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial vemarc
(i.e.a dog license or permit m burn leaves etc.)said person is NOT required to complete this affidavit.
The Department's address,telephone and flea number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
1 Congress Street,Suite 100
Boston,MA 02114-2017
Tel.#617-727-4900 ext 7406 or 1-877-MASSAFE
Fax#617-727-7749
Revised 02-23-I5 W Ww.mass.gOv/dia
V
sMrapce VA MMS COMMERCIAL GENERAL UAE UTY COVERAGE
PART DECLARATIONS
Renewal of Number NEW
PoficY No. 1261002552-0
Named Insured and Mailing Addresa N....,_cv.,c .um. a cw.r
Jonathan S.Soube
DBA Soutre Home Improvement
46 South St.
South Hadley MA 01075
Policy Period ' : From 071OW2018 to 0710 M19 at 12:01 A.M. Standard Time at Your mailing
address shown above.
IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE
WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POUCY.
LIMITS OF INSURANCE
Each Occurrence Limit $ 1,000,000
Damages To Premises
Rented To You Limit $ 100,000 Any one premises
Medical Expense Limit $5,000 Any one person
Personal and Advertising Injury Limit S 1,ODD,000 Any one person or organization
General Aggregate Limit $2,000,000
Products I Completed Operations Aggregate Limit $ $0001000
RETROACTIVE DATE(06 NO 02 ONLY)
coverage A eI mu,Iffmmmce dM aat rwphr n'bodily' j r-PMeb raps'wNch« Wd roe Mrwctire Dwe,
it any,shown here;
��pW�'Ir•I�WtlY�n4
DESCRIPTION OF BUSINESS AND LOCATION OF PI®ISES
Form of Business:
®Individual ❑Joint Venture ❑ Partnership ❑ Orgri intim(Other than Partnership or Joint Venture)
Business Description':
Remodeling
Location of All premises You Own, Rent or Occupy:
46 South SL SaM Hadley MA 01075
PREMIUM
Rate Advance Premium
Classification Code No. Pramarm Bas= Territory Prtco AN Other Pr/Co All Other
RanrcaGry-incl di g pity 01oBe 91300 P 2ZOOO 017 14227 23.134 $313 $509
classes shown on mpdred Lan ACL- PR
REM
See Allac ad ACD45LS
Minimum Premium Applies SlbWd for ACD-GLS S 250'00
Total or Minimum Premium $ 1,072.00
"(a) area (c) total cost (m) admission (p) payroll (s)gross sales (u)units (t)other
FORMS AND ENDORSEMENTS app"If to this Coverage part and made part of this policy, at time of =sue
SEE SCHEDULE OF FORMS AND ENDORSEN EHTS
Countersigned:'
By
Entry options if shaven in common Policy Declarations.
prizedRep entathre
+ Forms and Endorsements applicable to this Coverage Pad omdted it shown alpwwtmr the policy.
THESE DECIARATIONS AND THE COMMON POMY DECLARATIONS,F APPUGAM6 TOGEiNEt WITH THE COMIMON POLICY CONDITIONS.
COVERAGE FORM(S)AND FORMS AND EHDORSB03ITS.F ANY,—04,TO LOW A MIR THEREDF.COMPLETE THE ABOVE NUMBERED
POISY.
BUILDING INSPECTOR'S PLOT PLAN
20 WESTWOOD TERRACE
NORTHAMPTON, MA
$ PREPARED FOR W. MAREK INCORPORATED
w MON St.
EAS91AMPMK lu
&N-im
AUMW 7. 2019
P � 9C
a�.ast
mGARAGE
PAKJ
I
O NSE 420
S o
0 W/x
H
N BTW
N
D^ is
0
rn �"
,o9.,at 1
LOCUS REFERENCE:
BOOK 12839 PAGE 206
PLAN BOOK 47 PAGE 34, LOT 16
8
ASSESSORS MAP 35 LOT 135
ZONE WSP
FRONT SETBACK 20'
SIDE SETBACK 15'
REAR SETBACK 20'