29-455 (8) VIII. ZONING PLAN EXAMINERS NOTES a
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DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
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BOCA FORM APEBP - 669 C1969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
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*vett and Data - (For department use)
/ff min. .r44vgr tAeclos.p 74, /o.a
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and StA _ZIP code Tel. No.
1. rOwner or f�C0r� Q4* CD / e V 7Y�/C� �n< 0/04,0
Lessee of 7 r / �L 0ee"A/ _,E" HA , (D�g 4.
` / 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 f-LO/e0"A2 �/� Application date
,g %� Q 6 C�PE�ri V/E� 2,f1 7-20
/DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re uired Check Plan Review Date Plans B Date Plans B Notes
9 Fee Started y Approved y
BUILDING
PLUMBING $
MECHANICAL
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date
Permit or Approval Check Obtained Number By Permit or Approval Check e
PerDate
mit 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 ;.'. FOR DEPARTMENT USE ONLY
Permit number
Building. � � �t I ( Use Group
Permit issued i �.. ( W)(; 19
Building /�}1 /-1 /.`\ Fire Grading
Permit Fee $ A 1 1(1. Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $ A t / I
LE /
0 CITY OF NORTHAMPTON
• MASSACHUSETTS
•,. 'z )?�rl '
II�' .(2-:4 tr.:l OFFICE of the INSPECTOR of BUILDINGS°SW
ce,,,,.-.x-.,� Page Plot �� APPLICATION FOR
err
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant�to complete ,alll items in sections: I, I1, Ill, IV, and IX. 0
I. AT (LOCATION) `'�F �TIr� Al ei,e/v ' ZONING
DISTRICT'ow
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
V1
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
m
—I
1 I New building Residential Nonresidential
2 I I Addition(If residential, enter number 1217 One family 18 I Amusement, recreational
of new housing units added, if any
in Part D, 13) 131. I Two or more family — Enter 19 I I Church, other religious
number of units— — — — 20 LL Industrial
3 I j Alteration (See 2 above) 14 I I Transient hotel, motel,
21 I I Parking garage
4 I I Repair, replacement or dormitory — Enter number
5 I I Wrecking (If multifamily residential, of units — -)- 22 Li Service station, repair garage
enter number of units in building in 15 I 1 Garage 23 Li Hospital, institutional
Part D, 13)
6 Moving (relocation) 16 Carport 24 Office, bank, professional
7 I Foundation only 17 Other — Specify Ago 1fL` 25 I Public utility
/� 26 I School, library, other educational
B. OWNERSHIP Glead. MODE. 27 Stores, mercantile
8 V Private (individual, corporation,
28 I 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 $ 1 OD 0 school, secondary school, college, parochial school, parking garage for,
i 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.)
11. TOTAL COST OF IMPROVEMENT $ 00 j)
III. SELECTED CHARACTERISTICS OF B ILDING — 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 141/4
30 I Masonry (wall bearing) 40 IV/ Public or private company 48. Number of stories
31 I I Wood frame 41 I I Private (septic tank, etc•) 49. Total square feet of floor area,
all floors, based on exterior
32 I- 'Structural steel dimensions
33 I I Reinforced concrete H. TYPE,OF WATER SUPPLY
�Ij 50. Total land area, sq. ft.
34 I I Other — Specify 42 Public or private company
43 I I Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed
35 [VI Gas Will there be central air 52. Outdoors
36 I I oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 [_1 Electricity 44 Li Yes 45 Li No 53. Number of bedrooms
38 Li Coal
39 L•_ I Other — Specify Will there be an elevator? Fu II
54. Number of
46 H Yes 47 No bathrooms
Partial
4.0%
4
Department of Building Inspections
212 Mian Street
BUILDING
Northampton, Mass. 01060 0< 10.00
0 ipso PER IT
29 - 455
VALIDATION
/
DATE July 30, 19 84 PERMIT NO. 336
APPLICANT George Mettey ADDRESS 1,4 Crestview Driv, Flroence Owner
(NO.) (STREET) (CONTR'S LICENSE)
Addition Above Grou 0 Pool NUMBER OF
PERMIT TO �,) STORY DWELLING UNITS _
(TYPE OF IMPROVEMENT) NO. (PROPOS O USE)
64 Cre.view Drive ZONING URA AT (LOCATION) DISTRICT
(NO.) (STREET)
BETWEEN _ AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOC SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALL. OR FOUNDATION
(TYPE)
REMARKS: permit for the installation of an above • ound pool
AREA OR PER MIT
VOLUME ESTIMATED COST • FEE
(CUBIC/SQUARE FEET)
OWNER Same as applicant �► %,'
ADDRESS BY . i -, - _ ...r .:. s
dr
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - A'PLICANT COPY • P K 'SSESSORS COPY