29-297 (3) Vill. ZONING PLAN EXAMINERS NOTES
IX. SITE OR PLOT PLAN — For Applicant Use = ..
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants .�
Name Mailing address — \'umber, street, city, and State / ,/ 0/0 (,0 ZIP code Tell. No.
Owner or f0 i , e. le m XU
Lessee
Bpi Ider's
2. 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
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
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER is
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 numbers
Building Use Group
Permit issued 19
Building Fire Grading
Permit Fee $ lr)-
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�+ .# MASSACHUSETTS
• •
$ f OFFICE of th(e� INSPECTOR of BUILDINGS
T
Page `► Plot aU APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O
�( [� 1y d �i rcl l ZONING W
I• AT (LOCATION) , U f�r� � I � DISTRICT
LOCATION (NO.) (STREET) f L
OF BETWEEN PencaStle— AND_�ii`0 0
BUILDING (CROSS STREET) (CROSS STREET)
LOT
^� BLOCK SIZE SUBDIVISION t rrES— a te5 -SeG n Y LOT
i N
II. TYPE AND COST OF BUILDING — Ali applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use rn
rn
1 ❑ New building Residential Nonresidential
2 [i�`Addition(I/ residential, enter number 12 ®'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 F-1 Wrecking (If multi family residential, of units ——————— — -- 22 Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional
Part D, 13)
16 ❑ Carport 24❑ Office, bank, professional
6 ❑ Moving (relocation)
17 Other — Specify_.�6_1 25 ❑ Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 Ek<lvate (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,,,,,,•,•..,.... /5" 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 I$ 15�r
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 ❑ Public or private company 48. Number of stories..............
31 Wood frame 41 ❑ Private (septic tank, etc.) 49. 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 F-1 Public or private company 50. Total land area, sq. 4t. ..........
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
37E7 Electricity 44 Yes 45 No
__ . 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevator? Full..........
54. lJumber of
46 Yes 47 ❑ No bathrooms
Partial.......
vivo
DEPT. OP.BUILDING INSPECTIONS BUILDING `°- tD -06
Mlojoe Main Street o`
' rth MA 01060 PERMIT
�a
�() I,OffX 29 - 297 VALIDATION
J`J�]` DAATE 7 7 MiV 1 7- 19 ACI PERMIT NO. 326
APPLICANT RPVPrI\/ AndrpwS ADDRESS 191) Rrn Side rlr Owner
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO !,) STORY �/ '( DWELLING UNITS
TYPE 0 MPROVEMENT) NO. (PROPSSED USE)
ZONING II
AT (LOCATION) �7n Rrnnksida Ciy --- —DISTRICT
(N0.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: permit for the addition of a 469 sq ft. deck 4' high
AREA DR ESTIMATED COST $ 1 ,500.00 FEEMIT 10.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER Same as Applicant BU EP .
ADDRESS Same as Applicant's BY
WHITE - FILE COPY . GREEN - FIELD COPY CANARY - APPLICANT COPY • PINK - ASSESSORS COPY P -a lip