29-446 (2) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT ,Al I
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FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES 1 �"J
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IX. SITE OR PLOT PLAN — For Applicant Use
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NOTES and Data — (For department use)
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IV. IDENTIFICATION — To be completed by all applicants
4/1101111F.".
Name Mailing address — \'umber, street, city, and State ZIP code Tel. No.
1.
Owner or ! r/(6.e.
Lessee / ? !-'"'
,,f3 et, "� ,lr-G� L`S 'E AL <' i'37/ V:5,::;"3----
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Builder's
2. /7 // License No. 1/
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
�.« i")j1 Application date
f /c / 'r7 y/
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
Date Date
Permit or Approval Check
Obtained Number By Permit or Approval Check
Obtained Number 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 / 3
FOR DEPARTMENT USE ONLY
Y
Building.
Use Group
Permit issued �£- , c7,2/ 19ecro.Y..
Bui lding Fire Grading
Permit Fee $ y_li67
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $ ,
TITL
, CITY OF NORTHAMPTON
ri MASSACHUSETTS
�:�� `• ��i OFFICE of the INSPECTOR of BUILDINGS
:;,,,, '� Page _,`1.41 Plot -4146 APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, II, Ill, IV, and IX. O
I. rE t ��r�,__ (. ZONING MA
AT (LOCATION) `l/C /l. �--� DISTRICT VV
LOCATION (NO.) (STREET)
OF BETWEEN, AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D -1
m
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
--1
1 I I New building Residential Nonresidential
2 1i41 Addition(If residential, enter number 12) One family 18 I Amusement, recreational
of new housing units added, if any, r
in Part D, 13) 13 L I Two or more family - Enter 19 Li Church, other religious
number of units- - - - ---3. 20 I Industrial
3 I I Alteration (See 2 above)
14 I j Transient hotel, motel, 21 j Parking garage
4 I I Repair, replacement or dormitory - Enter number
5 I I Wrecking (If multifamily residential, of units - -91.- 22 I Service station, repair garage
enter number of units in building in 15 1 Garage 23 I Hospital, institutional
Part D, 13)
16 I I Carport _ 24 L___] Office, bank, professional
6I Moving (relocation)
17 K Other - Specify���/��Z1 25 Public utility
7I I Foundation only
26 I School, library, other educational
B. OWNERSHIP ><-7.- .0'11'7 27 I Stores, mercantile
8 j Private (individual, corporation, 28 Tanks, towers
nonprofit institution, etc.) 29 I Other - Specify
9 I 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 $ t7(_._)6. .L. / 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
b. Plumbing
c. Heating, air conditioning _„
d. Other (elevator, etc. G'Z"''f�"',' /C-'V(' i L.
11. TOTAL COST OF IMPROVEMENT $ .........5.7/a-6
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 f
k'V
30 I I Masonry (wall bearing) 40 Public or private company 48. Number of stories
31 tie,1 Wood frame 41 I I Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, base exte io
32 I Structural steel dimensions ...1.6...X..1 C. "..7Z
33 I Reinforced concrete H. TYPE OF WATER SUPPLY
34 I I Other - Specify 42 N Public or private company 50. Total land are'o, sq. ft. C CC
—
43 I I Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL 1. TYPE OF MECHANICAL 51. Enclosed
35,I Gas Will there be central air 52. Outdoors ,
36I I Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 L_j Electricity 44 I I Yes 45 No 53. Number of bedrooms 9
38 I I Coal
39 L i Other - Specify Will there be an elevator? Full / I
54. Number of
46 pi Yes 47 I No bathrooms
Partial
t;
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A
• A
partment of Building Inspections
212 Main Street BUILDING z° y Do ������
Northampton, Ma. 01060 PERMIT .a
a
29 - 446
VALIDATION
GATE April 91,E 19 89 PERMIT NO. 143
APPLICANT WoLfgaflg SchlpAaanr ADDRESS 34 Ellington Rd., Flo.
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Addition ( 1 1 STORY Family Room DWELLING UNITS 1 -
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) 34 ELt ington Road DISTRICT URA
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Addition
XIXIA♦ C)S TO BE 18 FT. WIDE BY 18 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: Addttton of family room
AREA OR VOLUME 32 ( $ 5,112.00 PERMIT $ 24.00
/ ESTIMATED COST FEE
(CUBIC/SQUARE FEET) -
OWNER Wilt fgang Srhlo s r BUILDING •EP . /
ADD R E SS 14 Etl in Qtnn Rd. , Florence, Ma. 01060 BY -a r . .( , _ L
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY
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