32C-130 (5) Vill. ZONING PLAN EXAMINERS NOTES
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NOTES and Data — (For department use)
IV. IDENTIFICATION To be completed by all applicants
Name Mailing address Number, street, city, and State ZIP code Tel. No,
Owner or
Lessee
Builder's
2.
License No.
Contractor
o4
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 W R I T E BELOW T H I S L I N E
V. PLAN REVIEW RECORD For office use
Plan Review Date Plans Date Plans
Plans Review Required Check Fee Started By Approved By Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL I$
OTHER I$
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
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 FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued 47 19
Building Fire Grading
Permit Fee Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $ ele-11
Plan Review Fee $ V
TITLE
CITY OF NORTHAMPTON
�. MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
, T Page Plot — APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, II, 111, IV, and IX. O
ZONING C
I• AT (LOCATION) DISTRICT
LOCATION NO') STREET)
OF BETWEEN AND
BUILDING
(CROSS STREET) (CROSS STREET)
"t LOT r '
SUBDIVISION LOT"'F BLOCK SIZE + ^ -
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D ;a
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use M
m
1 ❑ New building Residential Nonresidential
2 Addition(IJ residential, enter number 12 One family °� 18 ❑ Amusement, recreational
of new housing units added, if any, 13 Two or more family — "ter � 19 ❑ Church, other religious
in Part D, 13)
number of units— — — — 20 ❑ Industrial
3 Alteration (See 2 above)
14 Transient hotel, motel,
21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
22 Service station, repair garage
5 Wrecking (If multifamily residential, o units -i
❑
enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional
Part D, 13) 24 Office, bank, professional
6 ❑ Moving (relocation) 16 ❑ Carport
17 F-1 Other — Specify 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 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................ 'J _� 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.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
30❑ Masonry (wall bearing) 40 M Public or private company 48. Number of stories................ `
49
31 n Wood frame 41 ❑ Private (septic tank, etc.) . Total square feet of floor area,
all floors, based on exterior
32 ❑ Structural steel dimensions .....................
33 ❑ 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
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 ❑ Gas Will there be central air 52. Outdoors........................
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 n Yes 45 No 53. Number of bedrooms.......
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevator? 54. Number of Full..........
46 Yes 47 No bathrooms
Partial......
Fes.
DEPT. OF BdILDIWx INSPECTIONS BUILDING
�o
! 212 Main Street 0a C `-
Northampton, MA 01060 PERMIT
32C - 130 VALIDATION
DATE October 9, (g 86 PERMIT NO. 602
APPLICANT Stephen Brown ADDRESS 74 ConZXA St. Owner
IND.) (STREET) (CONTR•S LICENSE)
Alteration Existing Two/Add One Unit NUMBER of +1
PERMIT TO (_) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE) C
ZONING
AT (LOCATION)
74 Conz Street DIISTR CT S1
IND.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY vFT BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP SEME S OR FOUNDATION
(TYPE)
REMARKS: permit for t alterations o e i t o famil w llin Bus he addition
of another ni
AREA OR STIMATED COST $ 2� 000 00 FEEMIT 263.00 sQ.VOLUME
(CUBIC/SQUARE FEET) r .
OWNER Same as ADI 1 Cant BU
ADDRESS Same as' Aj)Q1 i cant ' S
BY 4nv—�-'r-1 -1
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY p}NT P