17D-012 (6) VIII. 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)
e- Ped/ (-71
IV. IDENTIFICATION — To be completed by all applicants --
Name Mailing address – Number, street, city, and State ZIP code Tel. No.
I. , • '4 ( )
Owner o r f):""'-`-‘: , • 1,..:":" 'r' '' / b''!'. //34; t ' ir'_!- r / j.. "i . /,, . r ' ,� ..) C
Lessee
Builder's s
2. ! ..}:;24 - '..f ., --- A.. % .1:14 - .l�'? - License No. .1t•'f 9/6
Contractor
:1 " /El, ; i/. C` 'V , r; �'' i-) {' j 6 '� / . - / `
3.
Architect or
Engineer
I hereby certify /that /the projosed work is authorized by the owner of record and that I have been authorized by the owner to
make,Rh"s app icat'on as Iyi's authorized agent and we agree to conform to all applicable laws of this jurisdiction.
f
Si re f a i i -- / Address Application date
1,/,,/- i ' t .. /,,.r �/
/, ,/ '— r, '1'7 __ "S ,, / i 7.t- - ' ''2.--, 1,-
r �/'
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re uired Check Plan Review Date Plans B Date Plans B Notes
q Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
ate ate
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 �� 1 FOR DEPARTMENT USE ONLY
Permit number
Pe i 1 {� Use Group
Building Fire Grading
Permit Fee $ r •6 - Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by: 1
Drain Tile , Az._--- .
Plan Review Fee $ ;'j � r j�`
G; j �
TITLE
CITY OF NORTHAMPTON
.- MASSACHUSETTS
't% �
; , i. 1fi OFFICE of the INSPECTOR of BUILDINGS
� �r b :_ P 0 4 Plot t APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, I1, 111, IV, and IX. /� // A 0
d t/ J_ �� /� T ` / I �y/Jr/ -- ZONING j ){� (�
I. AT (LOCATION) �' /"r ((OW `_ 1 , /f"J DISTRICT . f(—.CLSA
LOCATION (50.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION ``fl. 7V f'-!' "!f -.> - LOT BLOCK SIZE
H
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D -1
M
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For "Wrecking" most recent use m
m
1 1 New building Residential Nonresidential
2 I I Addition (If residential, enter number 12 ( 1 One family 18 I 1 Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 I I Two or more fomily - Enter 19 L j Church, other religious
number of unit's- - - - -0. 20 1_ 1 Industrial
3 I Alteration (See 2 above)
14 Transient hotel, mote, Ir
L_ h l 21 � Parking garage
4 Repair, replacement or dormitory - Enter number `
5 1 1 Wrecking (11 multifamily residential, of units - -0- 22 _ 1 Service station, repair garage
enter number of units in building to 15 L1 Garage 23 [1 Hospital, institutional
Part D, 13)
f 16 L 1 Carport 24 L_] Office, bank, professionol
6 Moving (relocation)
17 C1 Other - Specify 25 1_1 Public utility
7 1 Foundation only
26 Li School, library, other educational
B. OWNERSHIP 27 � Stores, mercantile
8 t.,l Private (individual, corporation, 28 L Tanks, towers
nonprofit institution, etc.) 29 Li Other - Specify
9 LI 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 of hospital, elementary
10. Cost of improvement $ ?Z-
school, secondary school, college, parochial school, parking goroge 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 "
d. Other (elevator, etc.)
11. TOTAL COST OF IMPROVEMENT $''j (
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.
30 I 1 Masonry (wall bearing) 40 1, 1 Public or private company Number of stories
31 L-J Wood frame 41 T Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 1 Structural steel dimensions
33 El Reinforced concrete H. TYPE OF WATER SUPPLY
34 1 Other - Specify 42 L __I Public or private company 50. Total land area, sq. ft.
43 1 1 Private (well, cistern) K. NUMBER OF OFF- STREET
PARKING SPACES
51. Enclosed
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
351 1 Gas Will there be central air 52. Outdoors
36 [__1 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 LJ Electricity 44 j ,1 Yes 45 No 53. Number of bedrooms
38 L_1 Coal
39 L _ I Other - Specify Will there be an elevator? Full
_ 54. Number of
46 L 1 Yes 47 '� No bathrooms
Partial