29-449 (2) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
..
�r� -
'334,
A4"
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IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
61( 75 Ie
Builder's
2. ` h1 No.
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
71e1-77 vt,;,L2 ./C/ ! L.L�l i�it Lt,‘el], )\U r. ..._ ' C�-4 iYc`, lia f f 5 n i
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
9 Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
roya Check l Chec Dumer Permit Approval Check Date
Permit or A umer
PP Obtaineare d
Number B y P it or A PP Number By
y
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 I FOR DEPARTMENT USE ONLY
Permit number S". 7
BUllding 7�7 Use Group
Permit issued 192
Fire Grading
Building
Permit Fee $ &COO, Live Loading
Occupancy Load
Certificate of Occupancy $
A d by:
Drain Tile $ .et,i ;‘
Plan Review Fee $
TITLE
NOTES and Data — (For deportment use)
0.4„,
1.11". CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS ) L..c T 5��
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 PLAN EXAMINATION AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, II Ill, IV, and IX. ,iii,./4
O
1 7-3 ZONING ,/1
I. AT (LOCATION) • +���! 4' iYLt VL. hi DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN .`'" L 1.4-,�'E.1'_1.ZC'C .i VsL AND
BUILDING (CROSS STREET) 73 (CROSS STREET)
LOT J
SUBDIVISION LOT BLOCK SIZE fU0><IOr)
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D —1
MI
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
m
I 14. New building Residential Nonresidential
2 I j Addition(If residential, enter number 12 n One family 18 Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 I I Two or more family - Enter 19 Church, other religious
number of units- - - - -•> 20 Industrial
3 I I Alteration (See 2 above)
14 I Transient hotel, motel, 21 Parking garage
4 I I Repair, replacement or dormitory - Enter number
5 I Wrecking (If multifamily residential, of units - 22 Service station, repair garage
enter number of units in building in 15 I Garage 23 Hospital, institutional
Part D, 13)
16 I Carport 241-1 Office, bank, professional
6I Moving (relocation)
171 I Other - Specify 25 Public utility
7 I I Foundation only
26 School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 I 1'1 Private (individual, corporation, 28 I Tanks, towers
nonprofit institution, etc.) 29 I Other - Specify
9 1 I Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential - Describe in detail proposed use of buildings, e.g., food
j processing plant, machine shop, laundry building of hospital, elementary
1,
10. Cost of improvement $ I C( 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 f ail:
b. Plumbing ),..5U.)/1
c. Heating, air conditioning /.6-C1.)
d. Other (elevator, etc )
11. TOTAL COST OF IMPROVEMENT $ > �-,UG'IC'
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 /<
48.30 VAasonry (wall bearing) 40 Public or private company Number of stories
31 Wood frame 41 I I Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior /
32 I I Structural steel dimensions 5/ .v
33 I I Reinforced concrete H. TYPE OF WATER SUPPLY
34 I I Other - Specify 42 Public or private company 50. Total land area, sq. fT. !Cat
43 I Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed
/
35 I 1 Gas Will there be central air 52. Outdoors
36 Ri Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 I I Electricity 44 I I Yes 45 1/No 53. Number of bedrooms
38 Coal
39 I I Other - Specify Will there be an elevator? 1 Full i
54. Number of
46 I Yes 471 - No bathrooms
Partial
R
I hereby certify that the proposea work is authorized by the gr`"of record
and I have been authorized by the owner to make this d4brr as his
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
P
DATE 19
c,_
DEPT. FILE COPY
Z(3
vpr.oF BUILDING INSPECn011e BUILDING
212 Main Street PERMIT
VALIDATION
400,r
Marthampton, Maus 010.0 29-449
DATE November 20, 19 78 PERMIT NO. 577
APPLICANT NormAn (1._ Panl F16411 ADDRESS 14B 11il wood La e„So. Hanley
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO New Residence ( 11 ) STORY Residence DWELLING UNITS
(TYPE OF IMPROVEMENT) NCI. (PROPOSED USE)
AT (LOCATION) Crestview Drive Lot #73 ZONING
DISTRICT URA
(NO.) (STREET)
a BETWEEN Off Brookwood Drive AND
m (CROSS STREET) (CROSS STREET)
a,
SUBDIVISION LOT 73 BLOCK SIZE E 100 X 100
a 24 U
O BUILDING IS TO BE 24 FT. WIDE BY 42 _FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
is
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
3 (TYPE)
Ft
° REMARKS: Construct one—family residence See plans for Lot #45
AREA OR
VOLUME 1008 ESTIMATED COST $ 229000 FEEMIT $ 66.DO
(CUBIC/SQUARE FEET)
OWNER Nnrman G. Paulsen it. 4111
ADDRESS 4& WigAwoocd LIMP f SO• Emil P7, a /�. ta.;'�'
(Affidavit on reverse side of application to be completed by authorized agent of owner)