29-290 (2) For ALL buildings within Fire District and for other buildings costing $10,000.00 or more, plans
and specifications must be submitted to the Inspector of Buildings for examination and approval. U
If building is to be moved give details relative to proposed location as for a new buildin j"
Application for Permit to B ild
Northampton, Mass.. ....... ..... ...... �.... ��19..f'l?..
To the Inspector of Buildings:- i
The undersigned hereby applies for a permit to build, move, alter, or repair, according to the
following specifications.-
1. Owner's name .......................» .............».......... ... ...... .......................................».......................................
2. Owner's address ........_.......».......... ...... ' ......».»............................».».»......._.........................
3. Architect's name .................. ... ............. »................
4. Builder's name k„ �"'! '-`'v"� »•••••••»•• •••••••••
...................».....»�� .. .....�............ ��/ ».............................. ^
5. Builder's address ............... ..»� ....................... !•!�....... ....... ...... .»°�.` ' �" �........
6. Location of Building. Street No. ................
.»... ...... : ... 5.../. L.x .......»................
7. Is this a removal or new building ............»,ras ..»............................».......................................................... , ....................
8. If removal, from where ..............».................. rfL.. ?..... ...... ........................ .......,,......................................
9. What is the purpose of building ............�;, �,�.../62: :.:z��.�f..... .................................
10. Material of building ...............;. ..........................................................»............................».........................................
11. If a dwelling, for how many families .......1......,.....................».....Number of rooms ...................................................
12. Is there to be a store in the building ...... ........».....................................................:......................................... .....
13. Size of building, No. of feet front .....y�,�......;No. of feet deep ..::.� .; No. of stories .....»�.......
14. Size of ell, No. of feet front ......... ; No. of feet deep ........... No. of feet high .........................
15. Size of Lot ....................»........,h •� ...............................Feet Wide ..,� ., ..... .. Feet Deep .................................
16. How near the-line of street. ,:.....: ,
17. How near the line adjoining lot. Right........... . ..:� ; Left ..... ,
.. .. .. �........... Rear .................»..............
18. Nearest building is ....., .g:- tt in a...................................................... direction ......................................................
19. Material of the floor........... L,tt..... :... ».. ..........................................»...............,....................................................._............................
20. Size of timbers, 1st ...,''..- 2nd ........................ : 3rd ........................; 4th ................/»...........; 5th ............................
21. No. of feet span ..............,Ir.. ..��...� ....................... ; Distance on centers .........1..6.................................................
22. Will the building be erected on solid or filled land ...............................................n.................
23. What is the material of foundation .....».......�`'..: ..»..........»...................».............; Footing ....mss `�...
24. Will the roof be flat or pitched ........ .: ................; Covering........... �.....................I..................
25. Heat; steam, hot water, furnace, stoves......:1. . ...................: Power oil burner ......... ..........................
26. Fireplace .....».r .............................................; Insulation ..........4_` s ...................................................................................
27. How many sinks 0...; Toilets »2....; Lavatories ..Q; Bathtubs..Q..; Showers.....; SettubsG....
28. City Service; Water ........9'.........Sewer ..........2.......; Road Surface .....; Sidewalk
...................... ........................
29. Is lot on accepted street ............. ..................................................................»..............................................
30. Estimated cost (must be filled out) ........». .............................»....».»..............................................»..............................................
Applicant agrees to give the Inspector of Buildings 24 hours' notice before lathing or
plastering this building. This,jmilding will conform to the requirements of the law.
Signatureof applicant ........,.. ......... ».......»....»............... ....».............»......................................................................
REMARKS No.......�.... .........
�
.................... .. ...L6. ..... ...... ................,.................................»... ».........................»....».».............»..........................
............»..................................»..........»....».......»..........................................................,.......................»......................................................................................
................................................»..........».............»....».»................».......................,............»........................................»...................».......»...............I.........................
............»...........».....................»................».......».......».............»...................................................................................................................................................................
APPLICATION �/��/ 4
Lot 2
Zoning Ordinance Sc,ction 10.2 1'cccivcc': File Po. Ilan bile
Owner ApI.-,licr!nt
Address Address /off R
Telephone Telephone P S�y-�07
This section is to be filled out in accordance r:i_t.h tt,e "TEble of Dimensional and
Density Re latione:. (Z. : ARTICLE VI)
Zoning Use Lot Front Depth Sutb-)c':c iax.Pld. Aiin. Op
District Area 7,lidth Side > _�r. _Coyer. Space
Exi.stin -- ��.-3. /'Df. b ` 26 �` %
Present Proposed
Clark the appropriate box to indicate the use of the parcel:
Q Non-Conforming Lot -rd/or Structure. Specify -----------------___—__
Residential Single F.? idly Unit DI'ulti-Family
[__j Dur-lex C]0 then
[� Busine_ss
= Industrial
[� Instituti or,-1
Q .Subdivision Q Regular 0 P.U.D.
Q Cluster 0 0ttier
Q Subdivision with ''Apgrov�.l-Not-Renuired��-Sump:
= Planning Board Approv,- l:
Q Zoning .Board Approval (Special Permit 1(`.q: Vj,.riance)
= City Council (Special Exception S. 10.10)
Watershed Protection District Overlvy: (Z.O. Sect. XIV) � Yes P'o
Parking Space Requirements: (Z.O. ,?ect. ".1) . Required Proposed
Loading Space Requirements: (Z.O; Cect. 8.2) Required Proposed
Signs: Z.0 Arta VII 0 Yec 110
Environmental Performance Standards: (Z,O, Art. XII) =Yes 0
_ 1
Plot Plan . Q Yes [5�j No Site Plan 0 Yes Q-Ido
(S. 10.2) (S. 10.2 and. 10.11
Waiver Granted: na to 0
This section for OFFICIAL use only
Q Approval as presented:
=Modific-atioiis necessary for approval:
=Return: (More information needed)
Q Denial: Reasons:
V,_AAXL al"<CZ/VLOV\
Signatu e of Applicant Date— _— �iiature Of Admin., Officer Date
I hereby certify that the proposed work is authorized by the owner of record
and l have been authorized by the owner to make this application as his
authorized agent.
SIGNATURE" OF AGENfi
ADDRESS
(NUMBER) (STREET) (CITY}
APPROVED BY TITLE
DATE 14
DEPT. FILE COPY
Z
,_
BUILDING
PERMIT VALIDATION
DATE 19 ��° PERMIT NO.
APPLICANT ADDRESS
D/ (NO.) (57R EE 7) (CONTR•S LICENSE)
I�.��(! NUMBER OF
PERMIT TO
%4-TYPE (`) STORY DWELLING UNITS
�
P OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) DISTRICT—
INTO (STREET)
a BETWEEN AND
b (CROSS STREET) (CROSS STREET)
a
LOT .�7 v a�
IL LOT BLOCK SIZE / /�,_v.�_
a
0 BUILDING IS TO BE_,�iL—�AL FT. WIDE BY�_FT. LONG BY * � FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
Z TO TYPE USE GROUP. BASEMENT WALLS OR FOUNDATION
I —_ F ITYPE)
X
0
I- REMARKS:
AREA OR ` PERMIT $
VOLUME ESTIMATED COST FEE
(CUBIC/SQUARE FEET)
OWNER
BUILDI G 0
ADDRESS BY
(Affidavit on reverse side of application to be completed by au agent of owner)