29-246 (7) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
IX. SITE OR PLOT PLAN For Applicant Use
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NO , S and Data — (For department use)
s
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IV. IDENTIFICATION — To be completed by all applicants
Name dtMailing address — Number, street, city, and Stag ZIP code No.
Owner or C O (5 I O<O C)
Lessee A I OC�Y Ue P�Ftmc 9- r+ss
2. n k j ( RoCle t4 ICU Rcl, License No. t74 C7
Contractor
06
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.
Signs re of Address Application date
So Pus4tn Grcte FlGizeklcL
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Dote Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Obtt t Date
a ed 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 mil/
Building Use Group
Permit issued 19 T._.
Building Fire Grading
Permit Fee Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
• CITY OF NORTHAMPTON
MASSACHUSETTS
$ f OFFICE of the INSPECTOR of BUILDINGS
Page
Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, II, III, IV, and IX. O
I• AT (LOCATION) � A ZONING
(JST/rt C/C G DISTRICT
LOCATION )"O•) `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
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 ❑ Repair, replacement or dormitory — Enter number f
5 ❑ Wrecking (lf multifamily residential, of units ——————— — -- 22 L� 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 — Speci/y 25 �❑ Public utility
7 ❑ Foundation only
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,,,,,,•••,,,,,,, C4 1 00 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 ..................... a
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 ) LSL� 48. Number of stories..............
y (wall bearing) 40 Public or private company
31 Wood frome 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 I. TYPE OF MECHANICAL 51. Enclosed .......................
35 Gas Will there be central air 52. Outdoors........................
36 Oil conditioning?
_ L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 ❑ Yes 45 4 53. Number of bedrooms..............
38 ❑ Coal
39❑ Other — Specify Will there be an elevators Full... .....
� 54. Number of
46 C vl
_ � Yes 47 No bathrooms
Partial.......
DEPT. OF BUILDING INSPECTIONS BUILDING z
212 Main Street 0 / U
Northampton, MA 01060 PERMIT
29 - 246 VALIDATION
DATE Apri 1 16, 87 191
Claude Rodri��l1ue (� us in CPER .
APPLICANT `( ADDRESS , j H�oo. wner
(ND.) (STREET) (CONTRIS LICENSE?
Alteration One Family NUMBER OF
PERMIT TO (_) STORY y DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
80 Austin Cir. , Florence 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 for the alteration of existing basement area to be renovated to create
storage area for existing single family dwelling
VOLUME 880 sg. ft. ESTIMATED COST $ 910.00 FEEMIT 10.00
Same FEET) +����!�9��/� � � r
OWNER .lame as Applicant BUILDIN?lV41'Z {`
ADDRESS Same as Applicant's BY
WHITE - FILE COPY I, GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY p1- SNP