29-468 (3) ZONING
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
IX. SITE OR PLOT PLAN For Applicant Use
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Moiling address — Number, stmt, city, and State ZIP code Tel. No.
,. 3►KA '100"J6 g Cti£S Irk)tCCJ Jl(tI —rJ0,tTlt4mITa.�I Y A-U 58���+?7
Owner or 01060
Lessee
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 Applicati n date
t
u�. Gt frTv,£,J U E— N to.Jt M, . a/06 a /6/2'7
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
q Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Obta t ed 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 (_ FOR DEPARTMENT USE ONLY
Permit number `C
Bui Iding t Use Group
Permit issued �'� 19
Building Fire Grading
Permit Fee $ ZO r
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $ ---�
Plan Review Fee $
h
TITLE
e
CITY OF NORTHAMPTON
�• MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Plot
Page �`� '` ��
nor g APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
E -S••rVI£W` D1 t`1Q� ZONING
I• AT (LOCATION) DISTRICT P�
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
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
M
1 X New building SLILD
Residential Nonresidential
20 Addition(If residential, enter number 12,X One family 18 Amusement, recreational
of new bousing units added, if any,
in Part D, 13) 13 Two or more family — Enter 19 Church, other religious
number of units— — — — --)' 20 Industrial
3 Alteration (See 2 above)
14 Transient hotel, motel, 21 Parking garage
4 Repair, replacement or dormitory — Enter number
— 22 L� Service station, repair garage
5 ❑ Wrecking (1l multifamily residential, of units ——————— — P 9 9
enter number of units in building in 15 Garage 23 Hospital, institutional
Part D, 13) ❑
16 Carport 24 Office, bank, professional
6 Moving (relocation)
7 Foundation only 17 Other — Speci/y 25 Public utility
26 n School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 Other — Specify
9 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,,,,,••.•....... T�� 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.)............
11. TOTAL COST OF IMPROVEMENT Is +Oa
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
30❑ Masonry (wall bearing) 40 Public or private company 48. Number of stories................
31 Wood frame 41 n Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior
32 Structural steel dimensions .....
X IZ........
33 Reinforced concrete H. TYPE OF WATER SUPPLY
34 Other — Specify 42F] Public or private company 50. Total land area, sq. ft. ..........
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ......................
35 Gas Will there be central air 52. Outdoors........................
conditioning?
36 � Oil L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 F] Yes 45 .y No 53. Number of bedrooms..............
38 Coal
39 Other — Specify NoAjIL Will there be an elevators Full..........
54. Number of +
46 Yes 47� No bathrooms
Partial......
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