29-221 (6) ZONING •
DISTRICT
FRONT YARD
SIDE YARD SIDE - .
REAR YARD
NOTES
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NOTES and Data — (For department use)
"44 I'-
f•s
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or �
Lessee 17 e/
Builder's (P
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 applicant Address ApplicatioAdate,
/
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 is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date
Permit or Approval Check Obta ned Number By Permit or Approval Check Date 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 �3
Bul[ding. Use Group
Permit issued 3a 19
Building Fire Grading
Permit Fee $ t�t� Live Loading
Certificate of Occupancy $ Otto ancy d
A r
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
9* *� MASSACHUSETTS
$ e
OFFICE of the INSPECTOR of BUILDINGS
"T Page 0197 Plot r APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. 0
a' yv, ZONING
I• AT (LOCATION) i_-�f�./JDISTRICT
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
m
1 ❑ New building Reside tial Nonresidential
2�Addition(If residential, enter number 12 .One family 18 ❑ Amusement, recreational
of new bousing 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 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) i1 D ❑
17� Other — Specify ��� � 25 Public utility
7 n Foundation only
26 School, library, other educational
B. OWNERSHIP 144-7 27 [ Stores, mercantile
8 X Private (individual, corporation, rf / A / 28 Tanks, towers
nonprofit institution, etc.) �Z/7 Ile 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 $ of ,Iv
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 WATER SUPPLY
34 �� Other p /y 42 Public or private company 50. Total land area, sq. ft. ..........
— S eci
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRIPAL TYPE OF HEATING FUEL I. PE OF MECHANICAL
35 Gas Will ere be central air 52. Outdoors.......................
conditio ing?
36 [ � Oil _ L. RESIDENTIAL BUILDINGS ONLY
37 [ f Electricity 44 L Yes 45 [I No 53. Number of bedrooms..............
38 ❑ Coal
39,X Other — Specify / Will there e an elevot Full..........
//// 54. Number of
46 es 47 [, No bathrooms
Partial........
w ,
Ao
DeparMeRn "5f Building Inspections
212 Main Street BUILDING z°
Northampton, Ma. 01060 PERMIT a
O<
29 - 221 �.. �
VALIDATION
DATE_April IQ- 19 82_ PERMIT NO. 155
APPLICANT atricia G Hathaway _ ADDRESS 112 Acrehrook Dr., Flo. _
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO AdAi Linn (1_) STORY EnclpcPd set ar etch DWELLING UNITS 1 _
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE
ZONING �A
AT (LOCATION) 112 ArrPhreek Drive DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Porch
0L%=7IS TO BE 10 FT. WIDE BY 23 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: Addition of solar JUMIMU enclosed porch - glass in front, wood on sides
AREA OR ESTIMATED COST $ ��O�O FEEMIT �P p 2
VOLUME
(CUBIC/SQUARE FEET) a
OWNER BUI P
ADDRESS BY 4 /�
-
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK ASSESSORS COPY