35-027 (6) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
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BOCA FORM APEBP — 669 01969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
O wner or EIAGENE 1. VdANA55E 336 5 YLVE5TER 0. Nd RTNAM TON MA55. O 10 1s0 5gN '
- '17y
O
Lessee
�l 4 Builder's
2. /7/y �� /1 J 0 wd✓'t'k 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 Application date
re's re K R 9. N-fA,*A
D0 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
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obta ned 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 1 19
Building (� Fire Grading
Permit Fee $ t 3(�5p`C i Live Loading
Certificate of Occupancy $ Occupancy Load
A roved �y:
Drain Tile
f
Plan Review Fee
TITLE
NOTES and Data — (For department use)
,r
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 7 PLAN EXAMINATION AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, It, 111, IV, and IX. O
y O /t 'T ZONING
I• AT (LOCATION) IV !I ./ DISTRICT'
LOCATION (NO.) (STREET)
OF BETWEEN FLORFNcal RaA9 AND WEST FARMS ROAD
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 Addition(if residential, enter number
12� One family 18 ❑ Amusement, recreational
of new housing units added, if any,
in Past D, 13) 13 ❑ Two or more family — Enter 19 ❑ Church, other religious
number of units- - - - ••->
3 F-1 Alteration (See 2 above) 20❑ Industrial
14❑ Transient hotel, motel, 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory - Enter number
• ------- - 22 ❑ Service station, repair garage
5 ❑ Wrecking (If multifamily residential, of units -�
enter number of units in building in 15❑ Garage 23 ❑ Hospital, institutional
Part D, 13) ❑
16 Carport 24 E] Office, bank, professional
6 ❑ Moving (relocation)
17❑ Other — Specify 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••,,,•.........• 10, u 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.)............ — C7
11. TOTAL COST OF IMPROVEMENT $ O 000
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 /
a�
30❑ Masonry (wall bearing) 40 ❑ Public or private company 48. Number of stories..............•
49. Total square feet of floor area
31 ® Wood frame 41 Private (septic tank, etc.)
all floors, based on exterior tJ
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. ........... Id S00
43 ❑ Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed ...................... O
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35❑ Gas Will there be central air 52. Outdoors........................
conditioning?
36 F-1 oil L. RESIDENTIAL BUILDINGS ONLY
37 X Electricity 44❑ Yes 45 X No 53. Number of bedrooms..............
38❑ Coal
39❑ Other — Specify Will there be an elevator? Full.......... 1
54. Number of I
46 ❑ Yes 47® No bathrooms
Partial.......
I 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 his
authorized agent. _ e
SIGKAi[ RE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
e
DEPT. PILE COPY
Z
BUILDING
CITY OF NORTHAMPTON PERMIT
VALIDATION
NORTHAMPTON, MA. 35-27
DATE july 18, 19 78 PERMIT NO. 287
APPLICANT_ Rigene T_ Ab9naRfip. ADDRESS 3-,6 Syl-yes'Eer Rd_ NItc)n_
(N0.) (STREET) (CONTR'S LICENSE)
PERMIT TO New Residence ( 1 ) STORY Residence DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
an Road ZONING
AT (LOCATION) Ry DISTRICT ASR
(NO.) (STREET)
w BETWEEN AND
(CROSS STREET) (CROSS STREET)
0 LOT
m SUBDIVISION LOT BLOCK SIZE
a
0 BUILDING IS TO BE 24 FT. WIDE BY 36 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
0;
0
)L REMARK
AREA VOLUME 864 ESTIMATED COST $ 10,000 PER $ -30.00
Eugene FEET)
OWNER Eugene T. Vanasse /
BOIL
ADDRESS 536 Syl yeptpr Rd NI tern BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)
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