25-062 ZONING •
CT
DISTRICT
USE
FRONT
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT
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NOTES and Data — (For deportment use)
C7 C
r
t
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
Owner or i
.z
Lessee L(-C. ,.mot � f'717
Builder's
1, r i 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 B Date Plans By Notes
Fee Sto. y rted Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obtai ed 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
V11. VALIDATION
Building , FOR DEPARTMENT USE ONLY
Permit number Building. Q �(,,,, � Use Group
Permit issued Xi 19
Building Fire Grading
Permit Fee
$ "v
Live Loading
Certificate of Occupancy $ Occupancy Load
Ap ed by: )
Drain Tile
Plan Review Fee $ ,�
TITLE
1
CITY OF NORTHAMPTON
MASSACHUSETTS
r r
e OFFICE of the INSPECTOR of BUILDINGS
$ - CCU D
,V, Page Plot I., APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
I. �Kl, d ZONING
AT (LOCATION) � ` � C--,�--�t DISTRICT
LOCATION (No.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
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
2Y Addition(I residential, enter numer
f ' umber 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 ❑ 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 ——————— — -i 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 r----� 24 ❑ Office, bank, professional
17 Other — Specify Awl— 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 ce s) 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..................... t
b. Plumbin g .................... _
\Z ',4 1 b
c. Heating, air conditioning.......... �.{ t
d. Other (elevator, etc.)............. 4�AC `� S 7
11. TOTAL COST OF IMPROVEMENT Is �j cc
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
..............
Number of stories. .
30❑ Masonry (wall bearing) 4017 Public or private company 48. t
31 ®.Wood frame 41 ❑ Private (septic tank, etc.) 49• Total square feet of floor area, \ �Z
all floors, based on exterior
32 Structural steel dimensions .....................
33 L❑ 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 I. TYPE OF MECHANICAL 51. Enclosed .......................
35 ❑ Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 es
❑ Y 45 7 No 53. Number of bedrooms..............
38 ❑ Coal
39 Other — Specify Will there be an elevator? Full..........
54. Number of
46 1 Yes 47 ❑ No bathrooms partial.......
a DEPT. OF BUILDING INSPECTIONS BUILDING Za
212 Main Street o
Northampton, MA 01060 PERMIT
25*62 VALIDATION
DATE A ril 26 19 85 PERMIT NO. 211
APPLICANT Margret & David Lac ins Cl ADDRESS 1 Old Ferry Road Owners
(NO.) (STREET) (CONTR'S LICENSE)
Addition Pool with Attached Dec4UMBER OF
PERMIT TO (_) STORY WELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 111 Old Ferry Road ZONING lJllL-1
DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
00 I (S TO BE 12 FT. WIDE BY 16 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: permit for the installation of an above ground pool with an attached to the house
deck
VOLUME 192 sq. ft. for deck ESTIMATED COST $ 3,000.00 FEE MIT 12.00
(CUBIC/SQUARE FEET)
Same as applicant
OWNER it to BUILD G
ADDRESS BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY ■ PINK - A SESSORS COPY p'INT IIP