29-468 (4) 1
1 --bnL>��-
!f
ZONING •
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
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NOTES and Data — (For department use)
IV. IDENTIFICATION - To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
Owner or , G� r .L��1� ? ICS J e
Lessee
t/ Builder's
2. 7 �� '"� �°"�� L iG� �l( (//� 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 oppl,ie". t Addre Application date
n
00 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 Is
OTHER Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number By Permit or Approval Chec Date Number B
Obtained 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 FOR DEPARTMENT USE ONLY
Permit number
Building — Use Group
Permit issued 19
Building �y / Fire Grading
Permit Fee $ ( J L—)D Live Loading
Certificate of Occupancy $
Occupancy Load
Approved by:
Drain Tile $ �s�a�i;eN��� f,�Eta► �„
Plan Review Fee $ (J
TITLE
CITY OF NORTHAMPTON
,. .� MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page— Plot WA, APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT L— Applicant to emplete all items in sections: 1, 11, III, IV, and IX. 0 NING
I• AT (LOCATION) .r,. (_. ! �SA)/C,G� 0/- �/��C} D�STR CT
LOCATION IN 0.) (STREET)
OF BETWEEN r�A~CiCi.CLC.'(n['� AND 1. rf 1.4 1, �
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
Ii. TYPE AND COST OF BUILDING — All applicants complete Parts A — D ;a
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
m
1 ❑ New building Re idential Nonresidential
2 Addition(If residential, enter number 12 One family 18 ❑ Amusement, recreational
of new housing units added, it 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
5 ❑ Wrecking (If multifamily residential, of units ------- — -i 22 ❑ Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 Hospital, institutional
Part D, 13)
16 ❑ Carport 24 ❑ Office, bank, professional
6 ❑ Moving (relocation)
17 Other — Spe c ily f 25 ❑ Public utility
7 ❑ Foundation only / 26 ❑ School, library, other educational
B. OWNERSHIP `( J /` 27 ❑ Stores, mercantile
8 ❑ Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 ❑J 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,,,,,,,,,,,,,,,,
— eL' school, secondary school, college, parochial school, parking go-rage 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 /� .II A qy�
a. Electrical..................... 11 1T-c _-o"I0 ,U ��JC)
b. Plumbing ..................... �Cy
c. Heating, air conditioning.......... t� /� 1
d. Other(elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT ,. , l III. SELECTED 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❑ Masonry (wall bearing) 40 Public or private company
31 Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 ❑ Structural steel ' dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other — Specify 42 Public or private company 50. Total land area, sq. ft. ...........
43 Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 ❑ Gas Will there be central air 52. Outdoors........................
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 ❑ -Yes 45 h No
53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevator° m Full..........
54. Number of
46 Fl Yes 47 '� No bathrooms
Partial.......
DEPIILDING INSPECTIONS BUILDING z0
212 Main Street 04
Northampton, MA 01060 PERMIT <a
29 - 468 VALIDATION
DATE Mav 10> 19 FAR PERMIT NO. 2(42
APPLICANT �hr,�,�, 1 �`eT�,;_Ye�ln� ADDRESS
(N0.) l3 REET (CONTR'S LICENSE)
RMIT TO
Deck & Pool One Family_) STORY NUMBER OF
UNITS
(
. .f (TYPE OF IMPROVEMENT) N0. (PROPOSED USE)
8 Crestview Dr. , Florence ZONING URA
AT (LOCATION) DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS, permit for the installation of an above ground pool with a 10'
X 12' attached deck
AREA OR 24' dia. Pool/120 sq. ft. deck 2,500.00 PERMIT 10.00
VOLUME ESTIMATED COST $ FEE $
(CUBIC/SQUARE FEET)
OWNER Same as Applicant
ADDRESS Same as Applicant' s 81UILDI
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK ASSESSORS COPY p0.1p