17A-057 (2) File#MP-2020-0051
APPLICANT/CONTACT PERSON ROLLINSON JOHN L&MARSHA S JANSON
ADDRESS/PHONE 195 BRIDGE RD
PROPERTY LOCATION 195 BRIDGE RD
MAP 17A PARCEL 057 001 ZONE URB(I00V
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
CLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee.Paid
Buildin2 Permit Filled out
Fee Paid
Typeof Construction:_ZPA- REBUILD& ENI A GE PORCH TO INCLUDE ACCESS TO ATTIC LIVING
SPACE BY STAIRS
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Buildiniz Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE P LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
Approved Additional permits required(see 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: §
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 Health 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
l �
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.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact the Office of
Planning&Development for more information.
RECEIVED
File No. �O-,a 0 -,S-/ �
ZONING PERMIT APPLICATIONS(§4 OF 4) 7 ) P)Cj
Please type or print all information and return this form o the Buildin
Inspector's Office with the X30 filing fee (check or money or ' ttablwtulcke
f HAti ION,NIA01060
City ofNorthampton
1. Name of Applicant: Jnky) Rol 6160A ® 3�✓1501,"-
0106a �fi3-�y�l-b33�
Address: Telephone:
2. Owner of Property: t1D` — R0 0 10.5D✓1 0 r1WA- A-8s0ki
Address: I I L5 ►J.� A6-, iq�. i�� D(D(, vZ Telephone: 1 3"�-`f K- b 3 3s`
3. Status of Applicant:
Owner X Contract Purchaser Lessee Other (explain)
4. Job Location: "(,, /�'��l�e,
Parcel Id: Zoning Map# 71q Parcel# District(s):
In Elm Street District In Central Business District
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property: -f Ax, 7 J,/it., 2rC 5f dcAce,
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
ol, flArack IV (fir,
iv " rLs
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO X DONT KNOW YES IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW YES
IF YES: enter Book Page and/or Document#
9.Does the site contain a brook, body of water or wetlands? NO DONT 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)
W:\Documents\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
10. Do any signs exist 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 x
IF YES, describe size, type and location:
11. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common
plan of development that will disturb over 1 acre? YES NO X
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
12. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION
This column reserved
for use by the Building
Department
EXISTING PROPOSED REQUIRED BY
ZONING
Lot Size
AV C#a2 e
Frontage
4o C/�e-
Setbacks Front
Side L: R: L: R: L: R:
Rear
Building Height
Building Square Footage
% Open Space: (tot area
minus building Et paved
parking
#of Parking Spaces
#of Loading Docks
No Ave- I'Vo A/e-
Fi I l:
(volume Et location)
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
Date: Applicant's Signature
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,
Historic and Architectural Boards,Department of Public Works and other applicable permit granting
authorities.
W:Oocuments\FORMS\original\Building-Inspector\Zoning-Permit-Application-passive.doc 8/4/2004
-NOTE-
THIS PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER SOURCES AND IS NOT
TO BE CONSTRUED AS AN ACCURATE SURVEY AND IS NOT TO BE RECORDED.
BUILDING LOCA'1ION ACCURACY IS NOT GUARANTEED
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0: INFINITY MORTGAGE COMPANY &
LAWYERS TITLE INSURNACE CORPORATION
TO THE BEST OF MY INFORMATION, KNOWLEDGE AND BELIEF
I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING
MONUMENTATION ALL VISIBLE 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—
SURVEYOR: ' �-j- THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
OF S —MORTGAGE LOAN INSPECTION PLLT=
cti NORTHAMPTON, MASSACHUSETTS
pgLL ��, PREPARED FOR
E. MARSHA .c.. JANSON & JOHN L. ROLLINSON, JR.
IZER u
135032 SCALE: 1 "=30 ' AUGUST 2 , 2002
ftli HAROLD L. EATON AND ASSOCIATES, INC.
REGISTERED PROFESSIONAL LAND SURVEYORS
235 RUSSELL STREET - HADLEY - MASSACHUSETTS