32C-149 (15) ZONING +
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and Statue ZIP`code T�etl. No.
Owner or
Lessee
e-
` . YYr-�✓' / � ✓ Builder's
2. Licens
s e No. 4 ✓ ✓
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
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans
Fee Started y Approved By Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approve I Check Date Number B Permit or Approval I Check Date Number B
Obtained y pP Obtained Y
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 lq
Building Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
Drain Tile $ Approved by:
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
la MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
"` .f�° ��;✓Q ZONING
I• AT (LOCATION) �►� l�`t .ice DISTRICT
LOCATION (NO') (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
H
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 m
1 New building Re idential Nonresidential
2 Addition(If 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
0
number o/ unzts— — — — > 20 Industrial
3 Alteration (See 2 above) 14 Transient hotel, motel,
u 21 F-1 Parking garage
4[;J epair, replacement or dormitory — Enter number
/ units ——————— — -� 22 Service station, repair garage
o
5� Wrecking (I/multifamily residential, -
enter number of units in building in 15 Garage 23 Hospital, institutional
Part D, 13) 16 Carport 24 Office, bank, professional
6 Moving p
g relocation) 17 Other — SpeciJy 250 Public utility
7 Foundation only 26 School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
28 Tanks, towers
8 Private (individual, corporation,
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,,,,,,,,,,,,,,,, school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office building at industrial plant.
T'o be installed but not included If use of existing building is being changed, enter pro�osed use.
in the above cost l 1
a. Electrical..................... �LLf`G,�:^ ` �J.•-; e �,._:7 -
b. Plumbing ....................
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT 1$
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. Number of stories...............
30 LZr asonry (wall bearing) 40 D, Public or private company
Cl Private (septic tank, etc.) 49. Total square Feet floor area,
41
31 � Wood frame all floors, based on exterior
32 Structural steel dimensions ...................
33 Reinforced concrete H. TYPEQF WATER SUPPLY
50. Total land area, sq. ft. ...........
34 Other — Specify 42 Public or private company
43 Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 [j��'Gas Will there be central air 52. Outdoors........................
36 [�] Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 C Electricity 44 n Yes 45 No 53. Number of bedrooms..............
38 Coal
39 n Other — SpeciJy Will there be an elevator? r' 54. Number of Full..........
46 [-1 Yes 47 bathrooms
n No Partial........
4S MANP
i+-
Y
Date Filed File No.
ZONING PERMIT APPLICATION
Zoning Ordinance Section 10 .2
1 . Name of Aloplicanct: XJ'. � &.
Address: Telephone:
2 . Owner of Property: A
Address: Telep one:
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet9 Parcel# /
Zoning Districts) / .
Street Address y
5 . Compliance with Zoning: Ex�st 'pg Proposed
Use of Structure/Property IL L `
Size of Structure (sq.ft. )
Building height '
% Building Coverage —
Setbacks - front
- side "r
- rear
Lot Size /U,,
Frontage P ,
Floor Area Ratio
% Open Space /
Parking Spaces
Loading Spaces
Signs
Fill (volume & location)
6. Narrative Description of Pro osed Work Pro 'ect: (Use
additional sheets if necessary)
7 . Attached Plans: Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained
herein is true and accurate to the best of my knowledge.
Date: -? Ca Applicant ' s Signature:
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented
Denied as presented
Reason for Denial:
Signature of BUIilding Inspector Date
y
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