29-415 (2) r
NOTES Vill. ZONING PLAN EXAMINERS
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
— REAR YARD
IX. SITE OR PLOT PLAN
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NOTES and Data — (For department use)
e Ile
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel.
Owner or
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.
Sigre o pplicant Address Application date
�� cl�9- 'le_
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re wired Check Plan Review Date Plans By Plans B Notes
9 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obta ned Number By Permit or Approval Check Obtai 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
11. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number C�
Building- Use Group
Permit issued 19 _
Building Fire Grading
Permit Fee $ OA ea
Live Loading
Certificate of Occupancy $ occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TI
i
a CITY OF NORTHAMPTON
MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page Plot y��� APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. /�" O
I• Ap(LOCATION) �C( �� / - DIOSTR CT44)- 1—
LOCATION ("O•) (s T)
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 New building Residential Nonresidential
2,K 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
3>< Alteration (See 2 above) number of units- - - - --> 20 Industrial
14 Transient hotel, motel, 21 Parking garage
4 E Repair, replacement or dormitory - Enter number
units ------- - --- 22 L� Service station, repair garage
o
5 � Wrecking (If multifamily residential, f
enter number of units in building in 15 Garage 23 Hospital, institutional
Part D, 13) 16 Car P ort 24 E] Office, bank, professional
6 Moving (relocation)
17 Other - Specify 25 Public utility
7 Foundation only 26 E] School, library, other educational
B. OWN RSHIP !��.�r CC-- 27 �� Stores, mercantile
B Private (individual, corporation, 28 ❑ Tanks, towers
��--``nonprofit institution, etc.) 29 Other - .Specify
9 D 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 I$
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 5-<Wood frame 41 E-1 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 42xPu6lic or private company 50. Total land area, sq. fi. ...........
43 [:�] Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE F MECHANICAL
35 LJ Gas Will there a central it 52. Outdoors.......................
36 Oil conditionin
L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 Yes 45 No
-� ---. 53. Number of bedrooms..............
38 �! Coal
39 �1 Other - Specify Will there be an e evator? Full..........
_ 54. Number of
46 Ye 47 Li No bathrooms
Partial.......
,�..x.�. .,�...
. .�. .__. ,r,_._� .._ r. _.�.
Y
1
DEPARTMENT OF BUILDING INSPECTIONS BUILDING
,*212 MAIN STREET PERMIT <a
NORTHAMPTON, MA. 01060
VALIDATION
29 - 412
DATE February 10, 19 at PERMIT NO. 59
APPLICANT T aRPa 8. CA1 1;nZ=nA ADDRESS 171 Sand Hiy 1l Rd-. Fln.
(NO.) STREET) ICONTR'S LICENSE)
NUMBER OF
• PERMIT TO All on & Add4 t9An (�1 1 STORY WAAA Stomp S„ sxi�- yAAI _DWELLING UNITS 1
"toll IMPROVEMENT) NO. (PROPOSED USE)
ZONING URA
4L.00A ) 121 Sandy Hill Road 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:
pool in spring
PERMIT
AREA OR
VOLUME ESTIMATED COST $ 600.0 FEE 10 nom_
(CUBIC/SQUARE FEET)
OWNER BUIL G D PT.
ADDRESS 1-71 SazLAy H4 1 7 RA_ , R1 aten o,MSS 01060 - BY
WHITE - FILE COPY . GREEN ^ FIELD COPY • CANARY - APPLICANT C PINK ^ ASSESSORS COPY