35-222 (4) ZONING •
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
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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.
1.Owner or - ���
� 15^ L/
Lessee
/� / q Bui Ider's
2 / la x /�� <�'1S. Zakj.C' /'' /7 (?. License No. C7('p;37
Contractor
Od�73
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.
SigpaturqR of applicant Address Application date
00 NOT WRITE ELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plan Review Date Plans Date Plans
Plans Review Required Check Fee Started By Approved BY Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number By Permit or Approval Check Date Number B
Obtained 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
V11. VALIDATION
Building i FOR DEPARTMENT USE ONLY
Permit number __ I
Building �q Use Group
Permit issued lq
Building �m Fire Grading
Permit Fee $_ tx/tx/ wvv(\l Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�. .g MASSACHUSETTS
$ OFFICE of the INSPECTOR of cj: Plot a BUILDINGS
Page APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. 0
ZONING
I• AT (LOCATION) DISTRICT
LOCATION IN0.1 r4 (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET) qq f
SUBDIVISION %TN K/af-7!'7 w)04-"q LOT BLOCK SIOZE
N
il. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE – For"Wrecking" most recent use m
1 F__1 New building Residential Nonresidential
2 LK Addition(If residential, enter number 120 One family 18 Ej Amusement, recreational
of new bousing units added, if any, 13 Two or more family — Enter 19 Church, other religious
in Part D, 13)
number of units— — — — --)• 20� Industrial
C�
3 Alteration (See 2 above) 14 Transient hotel, motel,
21 �� Parking garage
4 Repair, replacement or dormitory — Enter number
5 � Wrecking (1/multifamily residential,
of units ——————— — —� 22 �� Service station, repair garage
enter number of units in building in 15 n Garage 23 Hospital, institutional
Part D, 13) 16 C� Car art 24 Office, bank, professional
6 Moving (relocation) 17 Other t Specify Public utility
7 Foundation only )) 26 F-1 School, library, other educational
B. OWNERSHIP ✓ I / p1 S7,;/Ity' 199'.i 27 C 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•,••••••••••.... y U:d'i 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 t
a. Electrical....................... iv X
b. Plumbing ....................... (T)\ Cum /—A.12 j
c. Heating, air conditioning.......... 1 � ����
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $ �" we
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 L] Masonry (wall bearing) 40 Public or private company
41 Private (septic tank, etc.) 49. Total square feet of floor area,
31 Wood frame all floors, based on exterior
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. 41. ........... 9 [
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?
_ I
L. RESIDENTIAL BUILDINGS ONLY
� %
37 �� Electricity 44 � Yes 45 i` No 53. Number of bedrooms..............
38 Coal
39 Other — Specify Will there be an elevator .
Full.........
54. Number cf
46 1 Yes 47 'A N bathrooms
o
Partial.......
a DEPT. OF BUILDING INSPECTIONS gU1LDING z- ,° �(
212 Main Street o<
Northampton, MA 01060 PERMIT a a
XEXXX 35 - 222 VALIDATION
DATE NnvPmhPr 17, 19 RR PERMIT NO. 741
APPLICANT ScrAt Phanewf ADDRESS 38 Lad�icl i per 6d1>Q !ln Fi to
(NO.) "����{�I' (CONTR'3 110ENSE)
NUMBER OF
PERMIT TO I_) STORY DWELLING UNITS
F I PROVEMENT) NO. ( R USE)
pp ZONING "O7�
AT (LOCATION) (NO.) 36 Ladt.�Qr �8 1a2 DISTRICT
BETWEEN 1 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 the construction of a 24' X 40' 2 story addition onto single family dwelling
or extra living space 2 open rooms and a bathroom
AREA OR
VOLUME 960 sq• f t• ESTIMATED COST $ /2,000•00 PERMIT $ 288.00
(CUBIC/SQUARE FEET)
OWNER Same as Applicant j g �✓ ;
ADDRESS Same as Applicant's 0UIL
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY ^ APPLICANT COPY • PINK - ASSESSORS COPY pjNT IIP