35-201 (5) ZONING •
DISTRICT
SIDE YARD SIDE YARD
IX. SITE . 1
OR PLOT
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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.
7. ti - -
Owner or
C-)"CG(-, 5�-
Lessee
Builder's
2 License No. Jy�a(o6
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 Re wired Check Plan Review Date Plans B Date Plans B Notes
4 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
ate ate
Permit or Approval Check Obtained 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
II. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued �.4i/°�("( �C 19 Jr
Building f 11 Fire Grading
Permit Fee $ f�`� l Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�+ MASSACHUSETTS
r �
OFFICE of the INSPECTOR of BUILDINGS
t Page L� Plot— APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT — Applicant to complete all item��,s' in sections: 1, 11, 111, IV, and IX. o
(• AT (LOCATION) � �1 � ?���`'� � DIOSTR CT
LOCATION (NO.) (STREET)
OF BETWEEN �(�� AND
BUILDING / (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vs
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(/f 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❑J Industrial
3 ❑ Alteration (See 2 above)
14 ❑ Transient hotel, motel, 21 C� Parkin
4❑
Repair, replacement g garage
P P or dormitory — Enter number
5 ❑ Wrecking (11 multifamily residential, of units ——————— — -� 22 ❑ Service station, repair garage
enter number of units in building in 15 ❑ Garage 23❑� Hospital, institutional
P D, 13) 16 ❑ Carport 24❑ Office, bank, professional
6 ❑ Moving ng (relocation) P
7 ❑ Foundation only 17 Other — Specify 25❑ Public utility
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,,,,,,,,,,,,,,,, $ C, 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 ....................
1
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT I$
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 ❑ 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 ❑l 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........................
36 ❑ Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 ❑ Yes 45 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 ~ + ✓�
212 Main Street 7a `
Northampton, MA 01060 PERMIT
XZZ%XXXXAZX 35 - 201
VALIDATION
April 20, p 219
DATE 19 88 PER IT, NO.
APPLICANT Teddy Bear Pools ADDRESS 4t• , 7hicopee
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO Ind Pool (_) STORY One Family NUMBER OF
_y DWELLING UNITS
AE IMPROVEMENT) NO. (PROPOSED USE)
t_3OQ Burts Pit 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)
permit for the installation of an inground pool with a 41 fence surrounding it and a SE
REMARKS:
AREA OR ESTIMATED COST $ 6,000-00 FEEMIT $ 10.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER David Cloutier e�
ur $ 1 Road BUILDIN�p�P . A/•B►"'�
ADDRESS BY
WHITE - FILE COPY . GREEN - FIELD COPY a CANARY ^ APPLICANT COPY a PINK - ASSESSORS COPY p1 P