25-015 (42) WE CAN DETERMINE FROM THE APPLICATION AND THE ACCOMPANYING PLANS W HAT THE EXISTING CONDITIONS ARE AND
WHAT THE FUTURE CONDITIONS WILL BE.
Plans,in duplicate,mustbe filed with this application before a permit will be granted,one of which,upon issuance
of the permit shall be kept at the site during the progress of the work.
New..............�1
F
Addition........❑
_ � .........., Type.................... Map...................., Parcel..................... Alterations ....❑
JUN � � ����
i Repair............0
is , � ! ; ��
No. ........... ,
ne
l�! S 997 ate' CITY OF NORTHAMPTON Demolition....❑
r
DEPT OF SLIILDNG M'3SPE0011S
MASSACHUSETTS
NORTHWPTG r;�A 010 60
Application for other than a Dwelling Permit
(To be filled out in ink OR on a typewriter)
To the Building Inspector: Date.'97 ,• . . . ..................••• 19 9'1
Application for a permit is hereby made according to the following:-
1. Location, Street and ....... .. .......... . ..... . . ............... .. . .................................
2. Nearest cross street... ........ ... .. ... . . ........2 Y.?� ........................................ Lot No....................
- �� � ��
3. Owner's name ..... .... Ad ess ....... .......r..............................
4. Architect's name... . .... ... lJ .. ................ Address .. ......� �.......
.... .
5. Builder's name ........ .. .......j.:.... .... ....0 r :.......... Address .fit....... .... .. ...�rC ^ .
6. Use of building, Present..................................... Proposed .... .. .. .... ... .. .......... .. ....
7. Building fronts on how many Streets?........1..........................................................................................................
8. Is building in fire district?........., .>.........................................................}............................................. .......
9. Size of building,Width in ft. .......2.. l..............., Length in ft .Q............. Height in ft... ...J.........
10. Distance of building from Street Line./O.Q.", left lot linei.?�...-POI, right lot lined,"rear lot line 0� .!?0
11. Type of construction(check one): 1—A.......... 1-13 .......... 1---C .......... II.......... III.......... IV.......... V..........
Stories B 1 2 3 4 5 6 7 Roof
Story heights in ft.
Thickn's of walls in ins.
Material of walls t
Material of floor/roof
Design live load
Design dead load
Occupancy or Use
No.of persons/families
No.of stairs
12. Soil under footing is...:.. . .........................................................................................................................
ft. Will pile be used?zlze........................
13. Depth of footing below grade...�,�..........................� � ��--��--
14. Area of entire building(Present plus new) .......�...�..� ..... ... .a...CJ> a...... •• sq.ft.
15. Type of roof—flat....................... pitched...... ........ Material of roof covering ..................
16. No.of elevators./Za..... Method of heating.............. System ................................. Fuel .................................
17. Are live loads noted on drawings? ............... Are all zother structural conditions noted on drawings?.. .......
18. Building(will be)(is)equipped with sprinklers?.../.c�U.................... With sprinkler alarm?..............................
19. Is building to be used as a factory,workshop or mercantile or other establishment employing 10 or more persons?
....;?ZC6.......................................................................................................................................................................
20. Is building to be used as an office building,dormitory,hotel,family hotel,apartment or boarding house,lodging
house or tenement house having 8 or more rooms above the second story? .., ................................................
21. How many exits(per floor)to street? .....R...........................................................................................................
22. Is building a"Place of assembly"as defined by the General Laws? ....,l.Z D............................................... .........
23. Will building conform to the General Laws? . ...... .... Building and Zoning Ordinances?...�........
24. If a garage,distance from nearest building? ......... ....................................................................................I.......
25. If an addition,alteration or demolition,when was building erected?......................................................................
n
26. Estimated costs:~o The undersignedqrtifies ab ements are true to the best
General$.. l�T. ............................. of-his/her knowwedg�a d belief
Plumbin ... ...
............................
L�
Gas Piping..,-,?Z............................
Signature owner,architect or engineer
Sprinklers.7LO............................. WRITTEN DISCRIPTION OF WORK TO BE DONE pp
Heating (Use blank half of reverse side,if necessary) L
g... ..............................o p _ <
Electric .� ...... .. .. ..>?. ... .. .........
Other............................... .............. �........ . 1 r�z] 7`7 d
6 d .. ....... .................... . ..........
Total.$...�1.V��..................... ...... ..... .....
P�INT'S,11 P
10. Do any signs exist on the property? YES NO _
IF YES Mize,tYP e and location:
—�--
Are there any proposed changes to or additions of signs intended for the property?YES NOjk'
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This co7v to be filled in
by the Building Department
,Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks °
i
- side L: R: L:-660R: �q
- rear
Building height �-
Bldg Square footage I / ' (40 > G�
%Open Space: l "� l /
(Lot area minus bldg
' &paved Parking)
# of -Parking Spaces
f %f Loading Docks
Fill:
4vol-ume--& location)/
13 . Certification: I hereby herein
is true and accurate to
DATE: APPLI
NOTE: 1 uan e o a zoning permit doi;a
to comply with,ult
zoning ut ements and obtain all required permits from tne�, Health. Cohaervattor
Commission, Department of Publio Worku and other applicable permit granting authorities:
FILE #
j l { ''
Y� JINV 2 51997
' ) File No.
Di'i'l '-4 6biL rsu
m=tia�� NG PERMIT APPLICATION (§10 . 2)
P E TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: Yt
Address: Telephone:_
2. Owner of Property:
Address:
Tel
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: aA
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Propos e ork/Pro'ect/O ¢upation: tse Pd4tienal she is if ce'ssary):
h( cc
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KN01^: YES _ IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW_ t— _ YES T
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO—>-<�—' DON'T KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained ,date issued:
(FORM CONTINUES ON OTHER SIDE)
FILE # J y n A 4 .�
JM 5
APPLICANT/CAN AC PERSON: pot��
f�
iS 'uO`NE
PROPERTY LOCATION: _ 8-V 7 �v
MAP �`1e PARCEL: ONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM EMIXT) OUT
Rnilding Permit Filled niit
FeeRgid ✓�
% 0
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
/ Approved as presentedfbased on information presented
x Denied as presented: 1
Speci I ermit and/or Site Plan Required under: § 13•U ►��e-�^ i�rcu �I �/r/C+
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § i w/ZONING BOARD OF APPEALS ��
Received & Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
Received & Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
Permit from Conservati omm' s' l,'�`' �C V!00
Signature of uil g r t
NOTE:issuance of a zoning permit does not relieve an npplioant's burden to comply with all
zoning requirements and obtain c+ll required permits from the Board of Health, Conservation
Commission, Department of Public Works and other applionble permit granting authorttle-s.