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29-362 (3) ZONING • DISTRICT FRONT YARD SIDE YARD SIDE YARD REAR YARD NOTES IX. 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IDENTIFICATION — To be completed by all applicants Name �e q Mailing address — Number, reet, city, and State ZIP code Tel. No. Owner or Lessee � Builder's L. F3 0 License No. Contractor J 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 :�'ti � .� rim•t `+-�=' � ��' -z1� 5 - `� �`- 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 Dae Permit or Approval Check Obta ned Number By Permit or Approval Check Obta t ed 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 Use Group Permit issued 4ZL., 19�_ Building Fire Grading Permit Fee Live Loading Certificate of Occupancy $ Occupancy Load Ap ved by: � Drain Tile $ (Plan Review Fee $ TITLE CITY OF NORTHAMPTON MASSACHUSETTS $ OFFICE of the INSPECTOR of BUILDINGS �b .�i ,�. Page 41 Plot �P Z APPLICATION FOR ZONING PERMIT AND INSPECTOR BUILDING PERMIT IMPORTANT — Applicant to complete all items i sections: 1, 11, 111, IV, and IX. /� O �! ZONING L'& AT (LOCATION) � � DISTRICT T r l 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 rn 1 ❑ New building Residential Nonresidential 2 ❑ Addition(If 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 ❑ Industrial 3 � Alteration (See 2 above) 14 Transient hotel, motel, 21 ❑ Parking garage 4 F7 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) 16 ❑ Carport 24 ❑ Office, bank, professional ❑ 6 ❑ Moving (relocation) 7 ❑ Foundation only 17 Other — Speci/y 25 ❑ Public utility 26 ❑ 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,,,,,,,,,,,,,,,, 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.)............ qq 11. TOTAL COST OF IMPROVEMENT $d 3,J 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 ❑ 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 F. PRINCIPAL TYPE OF HEATING FUEL 1. TYPE OF MECHANIC 51. Enclosed ....................... 35 ❑ Gas Will there be central it 52. Outdoors........................ 36 ❑ oil con ioning? _ L. RESIDENTIAL BUILDINGS ONLY 37 Electricity 44 ❑ Yes 45 rte', No 53. Number of bedrooms.............. 38 ❑ Coal 39 ❑ Other — Spr ify Will there b an elevator? Full.......... 54. Number of 46 ❑ Yes 47 No bathrooms Partial....... apartment of Build Inspections 12 Main Street BUILDING Z0 F � orthampton, Mass. 01060 2d j PERMIT a 29 - 362 VALIDATION DATE May 9. 19 84 PERMIT NO. 186 APPLICANT Jo-Ann Pinard ADDRESS 219 Acre Broolt Drive Owner (NO.) (STREET) (CONTR'S LICENSE) Alteration One Family Home NUMBER of PERMIT TO ( _O. STORY DWELLING UNITS (TYPE OF IMPROVEMENT) N0. (PROPOSED USE) 219 Acrebrook Dr. 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 to replace od deck with new and converting existing windows to a pair of sli- ding glass doors AREA OR ESTIMATED COST $ 2,335.00 PERMIT Q 10.00 VOLUME �P (CUBIC/SQUARE FEET) OWNER Francis and Jo-Ann Pinard ADDRESS 219 Acrebrook Dr. BYIL WHITE - FILE COPY . GREEN - FIELD COPY - CANARY - APPLICANT COPY - PINK - ASSESSORS COPY