35-016 (2) r •
ZONING II
•
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and Statc ZIP code Tel. M
Owner or -�°"Z /'��.?�,�/ "r'✓ .
Lessee L`
/j Builder's
2 Z0117 License No.
Contractor l
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
7-7 8�
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date P y lans B Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER I is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or A rovaI Check Dote Number B Permit or A roval Check Date Number B
pp Obtained y pp Obtained y
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
II. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building- Use Group
Permit issued 198Q_
Building Fire Grading
Permit Fee $ 9rd, dG� Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $ / ,f
NO CITY OF NORTHAMPTON
1 +�
MASSACHUSETTS
4 OFFICE of the INSPECTOR of BUILDINGS
'"T Page _ � Plot %z APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. o
I• AT (LOCATION)_ ZONING .
LOCATION ("O•) � �"—' (STREET DlsrAlcT
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
V1
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D —+
A. 17FIMPROVEMENT D. PROPOSED USE -- For"Wrecking" most recent use M
m
1 w building Re XOne ntial Nonresidential
2 Addition(If residential, enter number 12 family 18 Amusement, recreational
of neu, 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,
4 Repair, replacement 21 C� Parking garage
p p or dormitory - Enter number
5 ❑ Wrecking (If 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 - Specify 25 L] Public utility
7 n Foundation only 26 � School, library, other educational
�
�
B. OWNERSHIP 27 L J Stores, mercantile
8 Private (individual, corporation,
26 Tanks, towers
nonprofit institution, etc.) 29 n 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,,,,,,,,,,,,,,,, ool, 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 $,-9
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..../.........
-y�
31 Wood frame 41 IXI Private (septic tank, etc.) 49. Total square feet of floor area,
/�� all floors, baseff��on xt io,�/
32 Structural steel dimensions ..ir. <- ...
33 Reinforced concrete H. TYPE OF WATER SUPPLY
// �` 50. Total land are o, sq. ft. ..........
34 �� Other - .Specify 42 n Public or private company
4 Private (well, cistern) K. NUMBER OF OFF-STREET
3 T
PARKING SPACES
51. Enclosed ............/........
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 L j Gas Will there be central air 52. Outdoors............f.........
36 Oil conditioning?
- _ L. RESIDENTIAL BUILDINGS (fit LY
37 Electricity 44 ' Yes 45✓�
/ No 53. Number of bedrooms......
38 Coal t""�`
39 Other - Specify Will there be an eleva,or? Full... ......
54. Number of
46 [ ) Yes 47 No bathrooms partial.......
l hereby certify that the.proposed work is authorized by the -owner' of record
and I have been authorized by the owner to make this application as hips •A
authorized agent.
�V � s
SIGNATURE O1" AGtN`t
ADDRESS �.:
(NUMBER) (STREET) (CITY)
z.
APPROVED BY TITLE
DATE I9
DEPARTMENT OF BUILDING INSPECTIONS Z o DEPT. FILE COPY
212 MAIN STREET BUILDING
O<
NORTHAMPTON, MA. 01060
PERMIT
x.35 - 16 VALIDATION
't
OAT 19 80 PERMIT NO._ 349
APPLICANT Clarence ES Dellislis ADDRESS_ RdWrria Rd� _ W"thamnton
(CONTR'S LICENSE)
PERMIT TO �y NUMBER OF
New residenr•e ( ) STORY $eSidQ=keP DWELLING UNITS 1
(TYPE OF IMPROVEMENT) 0, (PROPOSED USE)
ZONING
AT (LOCATION) Wes ad DISTRICT S
(NO.) (VT EET)
a BETWEEN AN AND
a CR 5 STR T) (CROSS STREET)
a LOT
M SUBDIV)SION BLOCK SIZE
Garage 24 16
U BUILDING IS TO BE 25 FT. WIDE BY 36
O . LONG BY FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
f
� (TYPE)
REMARKS: Wood and reinforced concrete, electric and solar wood heat, private sewaie
disposal, private water supply, 2 bedrooms, 1 full bath. t�
0 le-4 �+
AREA OR VOLUME ESTIMATED COST FEEMIT $ 9�'Q0
(CUBIC/SO UARE FEET)
OWNER — jameB 0masta BU41N
.
ADDRESS West Farms &dj,NO`on, BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)