23A-040 (13) 1- DEPT. FILE COPY
Z
BUILDING
PERMIT
VALIDATION
DATE JunP 6, 19 77 PERMIT NO. 210
APPLICANT Kenneth Fear11 ADDRESS 12 Renshaw Ave.
(NO) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO 0!nP_famil�r residence (�—) STORY Residence DWELLING UNITS 1
(TYPE OF I PROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) Mornin D idA Drive �t
(NO.) (STREET) DISTTRR I CT SR
rn BETWEEN AND
a (CROSS STREET) (CROSS STREET)
m SUBDIVISION Brookwood LOT 29 BLOCK S E 30,000
a
U
p BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
f
CC
(TYPE)
O
REMARKS: Construct C1T1P_fami1yr residence -
AREA OR
PER
VOLUME ESTIMATED COST $ 52,000 FEE $ 156.00
(CUBIC/SQUARE FEET)
X
OWNER Kenneth & Pai line FP_ArYI BUILDING .- /�/ADDRESS 12 Hens aw Avenue BY /O /2--/t—I-1/
Y'�
(Affidavit on reverie side of application to be completed by autho(T-izedragent of owner)
4°4t TO
CITY OF NORTHAMPTON G a
ZONING PERMIT APPLICATION 9 s j%;£� f6 f� //i"/� Tax Map No.// 13/) Lot /,-,1 - l I
Zoning Ordinance Section 10.2 6" Received: File No. Plan File
Owner " d,/-, .1/, 1. c_c{F`P1 Applicant ' (.; t-hr e
Address fr k® 1111'0 421 #. 0, ,v = Address / 2 _ ( k I i lr c, 1._1 /(•I v f
Telephone Telephone `/ `5 4.'
This section is to be filled out in accordance with the "Table of Dimensional and Density Regulations:
(Z.O. ARTICLE VI)
Zoning Use Lot Front Depth Setbacks Max. BId. Min. Op.
District Area Width Front Side Rear Cover Space
Past Existing R i 314,1-1-lC . 6 / ( iril 1 C ,'( % %
Present Proposed
Mark the appropriate box to indicate the use of the parcel:
❑ Non-Conforming Lot and/or Structure. Specify
Sid Residential )Single Family Unit ❑Multi-Family
❑ Duplex ❑ Other
❑ Business
❑ Individual
❑ Institutional
❑ Subdivision ❑ Regular ❑ P.U.D.
❑ Cluster ❑ Other
❑ Subdivision with "Approval-Not-Required"-Stamp:
❑ Planning Board Approval:
❑ Zoning Board Approval (Special Permit 10.9: Variance)
❑ City Council (Special Exception S. 10.10)
Watershed Protection District Overlay: (Z.O. Sect. XIV) ❑ Yes 0 No
Parking Space Requirements: (Z.O. Sect. 8.1) Required „4L Proposed
Loading Space Requirements: (Z.O. Sect. 8.2) Required./ A— Proposed
Signs: (Z.O. Art. VII) ❑ Yes CNo
Environmental Performance Standards: (Z.O. Art. XI I) ❑ Yes ,INo
Plot Plan Yes ❑ No Site Plan , Yes ❑ No
(S. 10.2) (S. 10.2 and 10.11
Waiver Granted: Date ❑
This section for OFFICIAL use only:
'Approval as presented:
❑ Modifications necessary for approval:
❑ Return: (More information needed)
❑ Denial: Reasons:
k , n, .
❑ , _ .
\,„,. , ,_, „., _, , , ,, , . , _ ,,„ _ 1 , ) , , / , , /
, x .____," , , ,,/_.7,,,/, ,,,
, _,,,T.,_, ,..„ ,,.._____ , /
Signture of Applicant Date Si nature of Admin. ' r Date
THE PRINTING PRESS
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Ntimb r, strrr°t, (rty and .'tatr° ZIP code Tel. No.
------ ----
O Kl n 4 e 0 o� 1 51 -�-
Owner or �'h��="�� �1rtH{.�� .—/f� ��C41 St�� � �
Lessee
1611,4;11e.
C/r(`F+rrt' )�'_� 'LS f�' _ Licene Builder's
2 . 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
DO 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
q Fee Started y Approved y
BUILDING
PLUMBING $
MECHANICAL $
ELECTRICAL
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date 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
Permit number 210
Bui lding
Permit issued June 6, 19 77
Bui lding
Permit Fee $ 156.00
Certificate of Occupancy S
Approved by:
Drain Tile S
•{
Plan Review Fee 5— cL
1 TI
+o, oy aI0
"t&,.1`-4 4i;ft City of NortI nnpton
r) iOA'- I
au Office of the nspertor of fluiCdings APPLICATION FOR
ZONING PERMIT AND
Page /1 il' i) Plot f 1" - 1 i BUILDING PERMIT
IMPORTANT - Applicant to complete all items in sections: I, 11, III, IV, and IX. Z
HO g O
I• AT (LOCATION) I 1O 1—Y1 j vj ) ;11C. t7 ri�r v (' DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUI LDING (CROSS STREET) (CROSS STREET)
//�-�, LOT -2,-1°, it"t Q
SUBDIVISION /✓ rt-;c ',', c e'( LOT Z" Cj BLOCK SIZE
CA
II. TYPE AND COST OF BUILDING - All applicants complete Parts A - D m
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use rn
1 INew building Reside ial Nonresidential
2 I I Addition(If residential, enter number 12I One family 18 Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 I I Two or more family - Enter 19 Church, other religious
number of units- - - - -ix. 20 Industrial
3 I I Alteration (See 2 above)
14 I I Transient hotel, motel, 21 [1 Parking garage
4 I ( Repair, replacement or dormitory - Enter number
of units - 22 Service station, repair garage
5 I Wrecking (If multifamily residential, Ir—/
enter number of units in building in 15 Garage 23 Hospital, institutional
Part D, 13) 24 Office, bank, professional
6I ] Moving (relocation) 161 Carport
17 I I Other - Specify 25 Public utility
7I I Foundation only
26 School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
28 Tanks, towers
8 Ij(Private (individual, corporation,
nonprofit institution, etc.) 29 Other - Specify
9 I I 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 $ S Z- 6;t1D 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
d. Other(elevator, etc.)
11. TOTAL COST OF IMPROVEMENT $
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. y
O
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS m
48. Number of stories 2'"
30 L J Masonry (wall bearing) 40 I I Public or private company
31 1.- ---Wood frame 41 Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 I I Structural steel dimensions 3 L 0
33 I I Reinforced concrete H. TYPE OF WATER SUPPLY
341 I Other - Specify 42 K Public or private company 50. Total land area, sq. ft. 30! ire—t;
43 1 I Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed r-
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 0
35 I I Gas Will there be central air 52. Outdoors
36 I3/0 il conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 I I Electricity 44 I 1 Yes 45 I '"No 53. Number of bedrooms et
38 I Coal ,
39 Other - Specify L.Ci,',' C t Will there be an elevator? Full
54. Number of �
46 1 I Yes 47 INo bathrooms Partial..2—:-...