35-221 (5) Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
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NOTES and Data (For department use)
y. 2
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — N;umber, sheet, city, and State ZIP code Tel. No.
Owner or
Lessee
Builder's C'd3
2 License No. G E l
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.
Signat a of applicant Address j' Appl�eation date
1
DO 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
9 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
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
VII. VALIDATION
Building r, FOR DEPARTMENT USE ONLY
Permit number
Building. r c� Use Group
Permit issued /%1��!✓? E�17^ 19 �-
Building _ Fire Grading
Permit Fee $ �� %�'t
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
o� ti CITY OF NORTHAMPTON
�• •� MASSACHUSETTS
$ 6 OFFICE of the INSPECTOR of BUILDINGS
$ ,�T Page -55 Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING
• AT (LOCATION) / f/'j_G'y s 4.L//`f /_`/i /—/1✓/ DISTRICT L�
LOCATION �± (NO.) (STREET)
OF BETWEEN ��t'— Ze7 i�la'- AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT >� �
SUBDIVISION LOT 6f BLOCK SIZE
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D -NI
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
M
1 New building Residential Nonresidential
2 Addition(If 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 L❑ 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 ❑ Hospital, institutional
Part D, 13)
6 Moving (relocation)
16 ❑ Carport 24�❑ Office, bank, professional
❑
17 F7 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 ❑ 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,••••••,•,••,••, f OG'U 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.......... r `�
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT is
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 2,0Ct
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 1. TYPE OF MECHANICAL 51. Enclosed .......................
35 ❑❑ Gas Will there be central air 52. Outdoors........................
36 Oil conditioning?
C J L. RESIDENTIAL BUILDINGS ONLY _
37 ❑ Electricit y 44 Yes 45 j No
38 53. Number of bedrooms..............
39 L Other — Specify Will there be an elevators Full.......... i
54. Number of
46 �j Yes 47 ❑ No bathrooms partial•,.....
Cit� of Nort4amptan
Offirt of tot )nsptrtor of JAnilbings
f
212 Main Street•Municipal Building
Northampton, Mass. 01060
H
CERTIFICATE OF OCCUPANCY
August 114, 1986
Page No. Plot 221
-w Lano/Lut #13
advs.,-D,
Building (Name) Address %�
Owner I art=y P Andottp Address 6, 1411 i L.E 10 df Ed. , SQUtilaffll)tO
Applicant Camp Address
Use: 1st Rc-\s,.&n is i Occupancy
2nd Occupancy
3rd Occupancy
4th Occupancy
Zone District SR
Required Inspections:
New Building Existing Building
Elevator Electrical
Plumbing Fire"
Building Other
Inspector of BuUdfngs
DEPT. OF BUILDING INSPECTIONS BUILDING ZD9� (�
212 Main Street 0<
Northampton, MA 01060 PERMIT <a
35 — 221 O VALIDATION
DATE September 26, 19 85 PERMIT NO. 570
APPLICANT L.P. Audette ADDRESS_ 68 Whiteloaf Rd. , Southampton 21237
(N0.1 (STREET) (CONTR'S LICENSE)
BER OF
PERMIT TO New Building (,) STORY One Family/Attached Gar LL NG UNITS 1
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
34 Ladyslipper Lane ZONING SR
A7 (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 for the construction of a new single family dwelling with attached garage
AREA ME 1fg� SCj, ft. ESTIMATED COST $ - ,,2!400.00 PERMIT $ 595.00
(CUBIC/SQUARE FEET)
OWNER Same as Applicant
ADDRESS ame as pp scan S BYILDIyG:ZaE�
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY •• PINK - ASSESSORS COPY PJNT IIP
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