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1290 Silas Deane Highway, Wethersfield, CT 06109
(203) 727-5567 or (203) 727-5543
ZONING •
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
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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 State ZIP code Tel. No.
Owner or `•LJ��V � �"S" �� f ��v�0 ��S (V ♦' kA W- �'`L
2�K .` 3 �l c v rz e�v
Lessee C G L G I'd.
2. Builder's
C ontractor 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
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans
Fee Started y Approved By Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number B Permit or A roval Check Obtained Number By
Obta i ned y PP
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
Permit number (y� FOR DEPARTMENT USE ONLY
Permi y
Building Use Group
Permit issued 19 _
Building L�OL— �) Fi re Grading
Permit Fee °e (/
Live Loading
Certificate of Occupancy $ Occupancy Load
Drain Tile
Approved by:
Plan Review Fee $
TITLE
" """ CITY OF NORTHAMPTON
$. MASSACHUSETTS
d OFFICE of g the INSPECTOR of BUILDINGS
Page cIi G Plot APPLICATION FOR
,�t �
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items int sections: 1, 11, 111, IV, and IX. G4 O
,�r .^� 6 r" �t/�a u E Z ZONING
I• AT (LOCATION) � DISTRICT
LOCATION "°'' STREET)
(
_, t, r e .
OF BETWEEN ( �z ` AND (CROSS STREET)
BUILDING (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
M
A. TYPE OF IMPROVEMENT D. PROPOSED USE – For"Wrecking" most recent use M
1 D New building Residential Nonresidential
2 1 Addition(If residential, enter number 12 1 One family 18 0 Amusement, recreational
of new bousing units added, if any,
in Part D, 13J 13 � Two or more family — Enter 19 Church, other religious
number of units— — — — --)0. 20 n Industrial
3 Alteration (See 2 above) 14 Transient hotel, motel,
21 C_� Parking garage
4 Repair, replacement or dormitory — Enter number rr
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) 25 Public utility
17 � Other — Specify
7 Foundation only 26 n School, library, other educational
B. OWNERSHIP 27E] Stores, mercantile
28 ❑ Tanks, towers
8 Private (individual, corporation,
nonprofit institution, etc.) 29�� Other — Specify
9 D Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food
�y 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.)............. / LL
11. TOTAL COST OF IMPROVEMENT Is G J'
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
48. Number of stories................
30❑ Masonry (wall bearing) 40 E�ublic or private company
41 Private (septic tank, etc.) 49. Total square feet of floor area,
31 L�ood frame all floors, based on exterior
32 Structural steel dimensions ..................... 3 �,
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY 3
50. Total land area, sq. ft. ...........
34 Other — Specify 42 P�Public or private company
43 [–] Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed ....................:.:
NM-
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
3vas Will there be central air 52. Outdoors........................ /1r,
r_J O � y
`— O il conditioning?
36 L. RESIDENTIAL BUILDINGS ONLY
37 j}�lectricity 44 Fl Yes 45 �0 53. Number of bedrooms..............
38 ❑ Coal
39 Other — SPecl y Will there be an elevator" Full..........
54. Number of
46 Yes 47 )<o bathrooms
A .— Partial.......
DEPT. OF BUILDING INSPECTIONS BUILDING Z.
! 212 Main Street 'Oa
Northampton, MA 01060 PERMIT
29 - 44 VALIDATION
DATE XARX Aug. 4, 19 88 PERMIT NO.
APPLICANT DnhQy% et{� ADDRESS Pioneer Knolls owner
(NO.) (STREET) (CONTR'S LICENSE)
Addition One Family UMBER OF
PERMIT TO I_) STORY y DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) 33 Pioneer Knolls DISTRICT AT
(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 a 1/2 bath addition
AREA OR 36 SQ. ft. ESTIMATED COST
2,675.00 PERMIT EE 1 0.00
VOLUME
(CUBIC/SOUARE FEET)
OWNER Same as Applicant P
ADDRESS Same as Applicant' s BYw�i t ZA
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY I,Odp