35-245 (3) ZONING
DISTRICT
USE
FRONT
SIDE YARD
SIDE YARD
REAR YARD
Ix. SITE OR PLOT PLAN For Applicant Use
....
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NOTES and Data — (For department use)
r
l
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, rity, and .State ZIP code Tel. No.
1.
Owner or C%
Lessee r A,� 7, Builder's
y, t_C�� u�" 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 By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL is
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number By Permit or Approval Chec Date Number B
Obtained Obtained 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
Bui(ding. p Use Group
Permit issued 94 19
Building Fire Grading
Permit Fee $ I '���� Live Loading
Certificate of Occupancy $ Occupancy Load
Ap oved by:
Drain Tile $
Plan Review Fee $
TITLE
v ixf' r
CITY OF NORTHAMPTON
�+ MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
Page `° Plot 4 APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. 0
i7 ZONING
3
I• AT (LOCATION) 011 �atlt�-S/' �'t'� F"��%�'� DISTRICT
-
LOCATION (NO.) / (STREET) t
OF BETWEEN '57Y`(4- �,CfC''��"jj�'i:F�7/-''. C'yr �C.C '- � L 'F= AND
BUILDING ( ROSS STREET) 2�y (CROSS STREET)LOT
SUBDIVISION �f? ��G� ('/`f LOT �JIJ BLOCK SIZE
CA
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D -4
A. TYPE OF IMPROVEMENT D. PROPOSED USE For"Wrecking" most recent use
M-1
1 M'New building Residen 'al Nonresidential
2 Addition(! residential, enter number
❑ J 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
3 ❑ Alteration (See 2 above)
number of units— — — — -+- 20❑ Industrial
14 ❑ Transient hotel, motel, 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (11 multifamily residential, of units ——————— — -i 22 ❑ Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional
Part D, 13) ❑
16 Carport 24 E] Office, bank, professional
6❑ Moving (relocation)
7 ❑ Foundation only 17 F-1 Other — SpeciJy 25 ❑ Public utility
26 ❑ School, library, other educational
B. OWNE SHIP 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 centts)_, , Nonresidential — Describe in detail proposed use of buildings, e.g., food
`=° 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 ....................
4�
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 1
30❑ Masonry (wall bearing) 40 ❑ Public or private company 48• Number of stories................
49. Total square feet of floor area,
31 �❑Wood frame 41 rivate (septic tank, etc.) all floors, based on exterior 1,_5'17-_
32 ❑ Structural steel dimensions .....................
33 Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other — Specify 42 ublic 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 as Will there be central air 52. Outdoors........................
ditioning?
36 ❑ Oil con L. RESIDENTIAL BUILDINGS ONLY
37 Electricity s i No
Y 44 _. 45 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevators Full.......... 17
54. Number of
46 ❑ Yes 47 [!!:(N o bathrooms
Partial........
DEPT. OF BUILDING INSPECTIONS BUILDING ,z,° $681.00
212 Main Street Oa
Northampton, MA 01060 PERMIT <a
35-r VALIDATION
DATE November 9, 84 PERMIT NO. 629
ADDRESS
APPLICANT R & L Realty Trust ' n us ry Ave.
(NO.) (STREET) (CONTR'S LICENSE)
NUMBE OF
PERMIT TO New Building (_) STORY One Famil�.yHome DWELLING UNITS 1
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
SR
AT (LOCATION)
30 Lady Slipper Lane DIDSTR CT
(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 one family home
AREA OR 1,547 sq. ft. ESTIMATED COST $ 93,350 FEEMIT 681.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER R & L Realty Trust
bb n us ry ve. , pring i.e , ass. BuIL C
ADDRESS BY
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY ■ PINC - ASSESSORS COPY p'INT Ilp
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
CITY NORTHAMPTON zson
.................O F........
--�
.................. FEE........................
No.. .-- .....
Utoposal Workii Touldrudivu �erntt
Permissionis hereby granted---------------------------------------•--------------------•-----------•-------•---------------------•--•---------••---•-•--.........._..._
to Construct (X) or Repair ( ) an Individual Sewage Disposal System
at No...... 1'..1P
------------------------
• _-°.'.°--------.__°---^--°---'_._.. r Street ..
as shown on the application for Disposal Works Construction Permit
....--&`-�'�------- Date ' ----�---!.�fy.......
........_ .
- - --
............................
Board ealth
------.°------....
DATE----------- �----
FORM 1255 A. M. SULKIN, INC., BOSTON
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
CITY N
or ORTH.A.M.P.T.O.N...............................................
............................... ........
(fertfiratr of constructed (�) or Repaired
RTI That he Individual S� ewage ..............••......
Individual ........................................
THIS Is 0
..LLS4_.._-------
......................................
---------------- In
Install
by------------ gybed i tile
.. . . . ----------- . ... .. ..... ......... Sanitary Code r
TITLE 5 of The S
e pro',"Si011sO State S,, -----------------
f
at------------ ......
has been in
stalled in acco
. .. . _3
the dated
orks Construction Permit No......_3N!� THAT THE
application for Disposal NV THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUAIAINTEE�
THE ISSUANCE OF ........
WILL FUIA ON SATISFACTORY. 'At ..............
SYSTEM .........i� .... ...........
C ----- Inspector-_ --------
DATE.....................