29-064 (23) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
611214
USE
r �
FRONT YARD
SIDE YARD /, ry SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
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BOCA FORM APEBP — 669 C1969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing ddresss — Number, street, city, and State ZIP code Tel. No.
Owner or
Lessee
Builder's
L.
License No.
Contractor C
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 a pplication as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signatur applica� Address � Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Rate Plaate Plan
Plans Review Required Check PIanFeeeview DStarttedns By DApproveds By Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Approval Check Number B Date um Approval Check N
Date
Permit or A umber B
PP Obtained y Permit or A 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
VII. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued ao 19$L_
Fire Grading
Building `
Permit Fee $ / ®s 0 Live Loading
Occupancy Load
Certificate of Occupancy $
Ap,wrpf d by.
Drain Tile $
Plan Review Fee $
TITLE
01 f
,NOTES and Data — (For department use) /
1
Mr-OF"UM01*01ECTUM
212 MNn it"t
�
P=kMwmoso APPLICATION FOR
_ PLAN EXAMINATION AND
J BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
% / ZONING U��4
I• AT (LOCATION) ,/ DISTRIC
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vr
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 KAddition(If residential, enter number 12 One family 18 ❑ Amusement, recreational
of new housing units added, if any, 13�❑ Two or more family — Enter 19 ❑ Church, other religious
in Part D, 13) number of units— — — —
20 ❑ Industrial
3 F-1 Alteration (See 2 above) 14 l
t
l
t
t h
i
Transenoe , motel,❑ 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 El Wrecking (If multifamily residential, o f units ——————— — -- 22 ❑ 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)
7 ❑ Foundation only 17 ❑ Other — Specify 25 ❑ Public utility
26 ❑ School, library, other educational
B. OWNERSHIP '14 27 ❑ Stores, mercantile
8 Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 0 T -*44 � 29 ❑ Other — Specify
9 ❑ Public (Federal, State, or
local government) �G
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•.,,,,,.,•••..•, /0 C/o 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.).............
11. TOTAL COST OF IMPROVEMENT $ 1,0 C/o
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 /
49• Number of stories.......
30�� Masonry (wall bearing) 40X Public or private company , ..
area
49. Total square feet of floor area,
31 Wood frame 41 E] Private (septic tank, etc.) all floors, based on exterior jL =G `'r VC—z r
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 there be central air 52. Outdoors........................
36 Oil condi ning?
L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 ❑ Yes 45 ❑ No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify W' ere be an elevator. Full.,/.....
� 54. Number of
46 ❑ Yes 47❑ No bathrooms
Partial........
r Ao
R r
Department of Building Inspection^ /
212 Main Street >k' = BUILDING
Nor�ihantpton, Ma. 01060 0 a
/' PERMIT
29 - 64 VALIDATION
DATE Jung 16, 19 81 PERMIT NO. 293
APPLICANT penald W. Sc2gai ADDRESS 31 Gilrain Terrace
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO ( �.__) STORY G'araffP DWELLING UNITS 1
•O •I PROVEMENT) NO. (PROI.OSED USE)
ZONING
(LOCATION) 31 Gilrain 'Pp ra _ o TIT URA
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Addition
)"][-]qM%X(S TO BE FT. WIDE BY 40 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: sddl *+ to $ to hn11SP)
AREA OR
VOLUME ESTIMATED COST $ 640 FEEMIT $ 10_n0
(CUBIC/SQUARE FEET)
t
OWNER pariq1ti W- Sr-ag_el
BUILDING
ADDRESS 31 ('ilrain 9'Prrare. iyorthampton, Ma. 01060 BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY