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NOTES
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NOTES and Data — (For department use)
CITY OF NORTHAMPTON .... O�
ZONING PERMIT APPLICATION Tax Map No:`� C Lot
Zoning Ordinance Section 10.2 Received: File No. Plan File
Owner tle{;rr � Sl �. EN Applicant A UL(L
Address t` � =, f �L_ t _, ti . Address3
Telephone Telephone
This section is to be filled out in accordance with the "Table of Dimensional and Density Regulations:
(Z.O. ARTICLE VI)
Zoning Use Lot Front Depth Setbacks Max. Bid. Min. Op.
District Area Width Front I Side Rear Cover Space
Past Existing
Present- _ Proposed
Mark the appropriate box to indicate the use of the parcel:
❑ Non-Conforming Lot and/or Structure. Specify
Residential ❑Single Family Unit ❑Multi-Family
❑ Duplex ❑ Other
Business
❑ Individual
❑ Institutional
❑
1-1 Subdivision Regular El P.U.D.
❑ Cluster ❑ Other
❑ Subdivision with "Approval-Not-Required"-Stamp:
❑ Planning Board Approval:
❑ Zoning Board Approval (Special Permit 10.9: Variance)
❑ City Council (Special Exception S. 10.10)
Watershed Protection District Overlay: (Z.O. Sect. XIV) ❑ Yes ANo
Parking Space Requirements: (Z.O. Sect. 8.1) Required Proposed
Loading Space Requirements: (Z.O. Sect. 8.2) Required✓/ Proposed
Signs: (Z.O. Art. VII) Yes O'No
Environmental Performance Standards: (Z.O. Art. XI 1) ❑ Yes No
Plot Plan ❑ Yes ❑ No Site Plan ❑ Yes ❑ No
(S. 10.2) (S. 10.2 and 10.11
Waiver Granted: Date ❑
This section for OFFICIAL use only:
❑ Approval as presented:
❑ Modifications necessary for approval:
❑ Return: (More information needed)
❑ Denial: Reasons:
Signature of Applicant Date Sig ature of Admin. Office Date
TH�PRwT�NG PR�SS
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — .A'iimber, strcc°t, i1N, aml Stntc° ZIP code Tel. No.
OWer or
Lessee
Bul
L ndse"4
- icee 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 app nt Address Application date
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
OTHER
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date D
Permit or Approval Check Obtai ed Number By Permit or Approval Check Obtta tned 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
Building
Permit issued 19
Building �r
Permit Fee
Certificate of Occupancy
Approved by:
Drain Tile
Plan Review Fee
�`� TITLE
GrtitV of Nort4ampton
a � �I�gs��ll�tsettg
(®ffire of the 3napertor of Wlbings
APPLICATION FOR
ZONING PERMIT AND
Pages ' Plot BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. p
I• ,� ZONING
AT (LOCATION) DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D 7�0
M
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use M
1'Z New building Residential Nonresidential
2 Addition residential, enter number
❑ 12 One family 18 ❑ Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 Two or more family — Enter 19 ❑ Church, other religious
number of units— — — — --)� 20 E] 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 ——————— — 22 ❑ Service station, repair garage
enter number of units in building in 15❑ Garage 23 ❑ Hospital, institutional \
Part D, 13) 24❑ Office, bank, professional
6 ❑ Moving (relocation) 16 ❑ Carport
17❑ Other — Specify 25 E] Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile S '
8 JX Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29Other — 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,,,,,,,,,•••,,., { °;-'.:'r 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 .................... S f f
c. Heating, air conditioning..........
d. Other (elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT $ fr
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. y
O
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS M
30 Masonry (wall bearing) 40 Public or private company 49• Number of stories...... area, ...
31 Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square Feet n floor area,
dimensions .... on exterior �r
32 Structural steel ••••••••••"""""' /7
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 ....................... r
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL O
35 X Gas Will there be central air 52. Outdoors.........../01 /.....
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37❑ Electricity 44 ❑ Yes 45 MNo 53. Number of bedrooms..............
38 ❑ Coal
39❑ Other — Specify Will there be on elevator? 54. Number of Full..........
46 ❑ Yes 47 �Na bathrooms partial........
I hereby certify that the proposed work is authorized by the ..owner of'record.
and I have been authorized by the owner to make this application as his
authorized agent.
SIGNATURE OF AGENT -
ADDRESS -
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE'
DATE 19
DEPT. FILE COPY
Zq
a 7-
BUILDING <4
CITY OF NORTON PERMIT
VALIDATION
NORTHAMPTON, MASS.
DATE July 5 197_ PERMIT NO. 276
APPLICANT Tuka F_ Scanlan ADDRESS 0 Drew,-,en Drive
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO _ P jA R17g�n (�' _) STORY AID llaut-e Serviee DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) MicRhel.man Avenue DISTRICT B Grp
(NO.) (STREET)
BETWEEN AND(CROSS STREET) (CROSS STREET)
LOT
IL SUBDIVISION LOT BLOCK SIZE
m
U
O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: T.3 fie g'araaa Storage - —
ARE OR VOLUME ESTIMATED COST $ 10,000 FEEMIT $ 30.00
(CUB(C/SQUARE FEET)
OWNER T ik F Scanlan ., -
BUILDIN DEPT
ADDRESS $Q nreXcan n-r Northampnn BY
,_ ��J
(Affidavit on reverse side of application to be completed by outho ' agent of owner)