29-248 (6) VIII. ZONING PLAN EXAMINERS NOTES to
filki
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
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NOTES and Data — (For department use)
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IV. IDENTIFICATION — To be completed by all applicants
4110*2
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner h1.4-So�v//.4-reo,/A! /8 Ea./Al 7C)& ��� /�6 .s�pq—
Lesse or 0!0 0 3� 76
Lessee iVC z AfA
./C610 / Builder's
2. License No.
Contractor
3.
Architect or
Engineer
I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to
make this application as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature of applicant Address Application date
/1 ,-t ltd ezci4/6 ��.c! �� � 4/cE 6/i9/
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number By Permit or Approval l Check Date Number B
Obtained y pp Obtained By
BOILER PLUMBING
CURB OR SIDEWALK CUT ROOFING
ELEVATOR SEWER
ELECTRICAL SIGN OR BILLBOARD
FURNACE STREET GRADES
GRADING USE OF PUBLIC AREAS
OIL BURNER WRECKING
OTHER OTHER
VII. VALIDATION
Building
Permit number FOR DEPARTMENT USE ONLY
1(i\
Building y • Use Group
Permit issued 4'"�, C7Z ( 19
Building Fire Grading
Permit Fee $ JO. OD Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile
Plan Review Fee $ /J
TITLE
zf CI. - NORTHAMPTON
CHUSETTS
r i OFFICE of the INSPECTOR of B Page "l o� APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
• z
IMPORTANT — Applicant to complete all items in sections: 1, 11, III, IV, and IX.
0
I. AT (LOCATION) /8 �/A,V9 O� ��, ,q.( ZONING
DISTRICT
LOCATION (NO.) (STREET) //
OF BETWEEN B/ZOO/1N!0C�/J L//e V4E_ AND , '6'6 ii / Oxi J_
BUILDING (CROSS STREET) (CROSS STREET)
�} LO / G�
O ! .;-
,S,F
SUBDIVISION LOT 1 l BLOCK SIZE T !21 /
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D -i
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use rn
rn
-1
1 I I New building Residential Nonresidential
21 I Addition(If residential, enter number 12 I One family 181 I Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 I I Two or more family — Enter 19 L j Church, other religious
number of units— — — — -i 20[1-1 Industrial
3 rgi Alteration (See 2 above) 14 Transient hotel, motel,
21 [_1 Parking garage
4I I Repair, replacement or dormitory — Enter number
5 I I Wrecking (If multi family residential, of units — --_ 22 LLI Service station, repair garage
enter number of units in building in 15 I I Garage 23 LII Hospital, institutional
Part D, 13) 16 I I Carport 24 L J Office, bank, professional
6 I I Moving (relocation)
17 y Other — Specify Ai?0Y-E. 25I__J Public utility
7I I Foundation only
26 L_ I School, library, other educational
B. OWNERSHIP 6/ 4 U.elf.> ,/''cx)L 27I _] Stores, mercantile
8 Private (individual, corporation, /6K r 28 Tanks, towers
nonprofit institution, etc.) V �� ���GK - j 29 I _ [ Other — Specify
9 [ I Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement $ 1c00 6/ school, secondary school, college, parochial school, parking garage for
department store, rental office building, office building at industrial plant.
To be installed but not included If use of existing building is being changed, enter proposed use.
in the above cost
a. Electrical Soo
b. Plumbing
c. Heating, air conditioning
d. Other (elevator, etc.)
11. TOTAL COST OF IMPROVEMENT $;j�1J(::)i `‘ _
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
for wrecking, complete only Part J, for all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
48. Number of stories
30[ I Masonry (wall bearing) 40 I I Public or private company
31 [ I Wood frame 41 PI Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 I Structural steel i dimensions
33 Li Reinforced concrete H. TYPE OF WATER SUPPLY
34 _J Other — Specify 42 L_J Public or private company 50. Total land area, sq. ft. $cQ
L
43 I__i Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
_ 35 I I Gas Will there be central air 52. Outdoors
36 L_i Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY •
37 LiJ Electricity 44 L-] Yes 45 i' No 53. Number of bedrooms
38 LI Coal
39 L ' Other — Specify Will there be an elevator's Full
54. Number of
46 Ti Yes 47171 No bathrooms
Partial
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