35-037 (9) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
IX. SITE OR PLOT PLAN For Applicant Use
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, s ret, city, and State yZIP code Tel. No.
t
Owner or "L�� ' Cr..� �' f '�'V (✓^�'-� 3
Lessee
CjlG Ct
Builder's
2. r I License No.
Contractor t
3.
Architect or
Engineer
I hereby certify that the proposed work is authorized by the owner of record and that I hove 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.
Signjur�e (ol f gppl'�ant _ Address Applica ion ate
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 Is
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number B Permit or Approval Check Date Number
Obtained y pp Obtained 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
II. VALIDATION
Building Q` FOR DEPARTMENT USE ONLY
Permit number
Bui(ding. y/ t Use Group
Permit issued �nG V A,Z�Z 19
Building Fire Grading
Permit Fee $ Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�. MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
wr Page -' Plot i APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. {� O
Q 12 /p ZONING ?E�'
I• AT (LOCATION) ') C (. - DISTRICT' •�.
LOCATION fNO7 (STREET)
OF BETWEEN i' & 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 rn
rn
1 ❑ New building Residential Nonresidential
2 ❑ Addition(I/ 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
5 �❑ Wrecking (If multifamily residential, of units ——————— — -- 22 Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 L❑ Hospital, institutional
Part D, 13) ❑
16 i Carport 24❑ 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 L❑ 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......... GYM
d. Other(elevator, etc.)............. p
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 (wall bearing) 40 ❑ Public or private company 48• Number of stories...............
31 Z 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 OF WATER SUPPLY
34 ❑ Other — .Specify 42 X Public or private company 50. Total land area, sq. ft. ...........
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
_ PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 ❑ Gas Will there be central air 52. Outdoors........................
conditioning?
36X Oil L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 ❑ Yes 45 !j1 No 53. Number of bedrooms..............
38 ❑ Coal
39 Other — Specify Will there be an elevator? Full..........
54. Number of
46 ❑ Yes 47 ❑ No bathrooms
Partial.......
a DEPT. OF BUILDING INSPECTIONS BUILDING Z° '50,. X
! - 212 Main Street 04
IL
Northampton, MA 01060 PERMIT
35 - 37 VALIDATION
DATE March 14, 19 86 PERMIT NO. 85
APPLICANT Matthew R. Kinlock ADDRESS Loudville Rd. , Easthampton 001436
(NO.) (STREET) (CONTR'S LICENSE)
Alteration One Famil y NUMBER OF
PERMIT TO (_) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
198 West Farms Road ZONING SR
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 is for interior alteration - unfinished upper story
AREA OR ESTIMATED COST $ 14,000.00 FEEMIT $ 40.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER Joseph & Susan Wernik D-_
i
ADDRESS 198 West Farms Road. Nortlinm ton BY ---
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY p0--fP