29-385 (3) ZONING •
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 it w
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
Owner or
Lessee
Builder's
1.
License No.
Contractor /yw„-}
3. G�
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.
Signatur pplicant Address Application date
c O 5 AJ44 cy �L f�d.1 f 2-130
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
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obtained 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
Building Use Group
Permit issued t as 19 �
Building Fire Grading
Permit Fee $ Live Loading
Certificate of Occupancy $ Occupancy Load
A r v by:
Drain Tile
Plan Review Fee
TITLE
" o CITY OF NORTHAMPTON
9� .8 MASSACHUSETTS
�b OFFICE of the INSPECTOR of BUILDINGS
p
Page Plot > b
g APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, lll, IV, and IX. O
7 ZONING
• AT (LOCATION) 6 S lac; O k-Lo a C'1) """iL L (J� DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vr
II. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use M
M
1 ❑ New building Residential Nonresidential
2 ❑ Addition(If residential, enter number 12Z 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 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)
17❑ Other - Specify 25 ❑ Public utility
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP 27 L❑ Stores, mercantile
8 Private (individual, corporation, ^ �- • 28 ❑ Tanks, towers
nonprofit institution, etc.) 1+ 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.).............
11. TOTAL COST OF IMPROVEMENT $
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 N 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 O 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 1. TYPE OF MECHANICAL
35 Gas Wi here be central air 52. Outdoors........................
36 ❑ Oil conditio
L. RESIDENTIAL BUILDINGS ONLY
37� Electricity 44 ❑ Yes No 53. Number of bedrooms..............
38 ❑ Coal
39F-] Other - Specify Will t re be an elevator? °t.- Full.........
_ 54. Number of
46 ] Yes 47 ❑ No bathrooms
- Partial.......
w
INSPECTION RECORD
DATE NOTE PROGRESS - CRITICISMS AND REMARKS INSPECTOR
ZPARTWI OF BUMI)ING MSPECTMONS FIELD COPY
12 MAUI SMUT BUILDING )
NOMWOn0, MA. 01060
PERMIT
29 - 3135
DATE December 30, 19 80 PERMIT NO. 763
APPLICANT Patricia A ADDRESS 35 Brookwodd Drive {
(NO.) (STREET) (CONTR'S LICENSE)
Fire repair & new NUMBER OF
PERMIT TO Wood st"e ( I STORY - DWELLING UNITS 1
(PROP
(TYPE OF IMPROVEMENT) NO. OSE USE)aye
Drive ZONING URA
AT (LOCATION) DISTRICT
(NO.) (STREET)
a BETWEEN a, AND i
�o (C OSS STREET) (CROSS STREET) i
i
LOT
a SUBDIVISION LOT BLOCK SIZE
m
u BUILDING IS TO BE T. W DE�,Y FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
. � 1
Z TO TYPE USE GROUP N' BASEMENT WALLS OR FOUNDATION
� (TYPE) 1
ill Oa REMARKS: ZII3tal I wood-burning stave in existing t1h4 ri1 ey_
Repair fire damage to living room. I
AREA OR i10VsV1J FEE ,fin no
VOLUME ESTIMATED COST $ pair In.
no
FEET)•
OWNER Patricia Stout B
ADDRESS 35 $r0@iCwttOd DT.s Florence* Ma, 01060 B