29-341 (4) ZONING
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR •
Applicant
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NOTES and Data — (For deportment use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, streel, city, arui Slate ZIP code Tel. No.
1. G `ld' 01040 $?6-&3
Owner or
Lessee
Builder'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
lI�2...� r,'� ,�e��,,.,� /�a'�c�411-
00 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 $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
te Date
Permit or Approval Check obtaained Number By Permit or Approval Chec 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
II. VALIDATION
Building S('�('J FOR DEPARTMENT USE ONLY
Permit number 1�S jj�5
Building• �1� � f / Use Group
Permit issued 1 C Zz 19�
Bui(ding / ,�%� Fire Grading
Permit Fee $ (/./'.
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
T Page 2 !Z Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING /
I• AT (LOCATION) �',. / DISTRICT&
LOCATION (NO.) L (STREET)
OF BETWEEN .re koc'�. AND Dfr1lr Q1/le-
BUILDING (CROSS STREET) (CROSS TREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
m
1 ❑ New building Residential 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
number of units— — — — --> 20❑ Industrial
3 ❑ Alteration (See 2 above)
14 ❑ Transient hotel, motel, 21 ❑J Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (If multifamily residential, of units ——————— — -i 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)
7 ❑ Foundation only 17 ❑ Other — Specify 25❑ Public utility
26❑ School, library, other educational
B. OWNERSHIP 27❑ Stores, mercantile
8 LV 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
school, secondary school, college, parochial school, parking garage for,
10. Cost of improvement,,,,,,,,,,,,,,,,
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 1$ 0C)
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 [y 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 El 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 1. TYPE OF MECHANICAL
35 ❑ Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 Cj Electricity 44 Yes 45 [:] No
53. Number of bedrooms..............
38 ❑ Coal
39 Other — Specify Will there be an elevator? 54. Number of Full..........
46 ❑J Yes 47❑ No bathrooms
Partial.......
i a DEPW. UILDING INSPECTIONS BUILDING Z°
! 212 Main Street 0a $10.00
Northampton, MA 01060 PERMIT
29 - 341 VALIDATION
DATE October 19, )g 84 PERMIT NO, 588
APPLICANT Marianne Berlin ADDRESS 118 Austin Circle Owner
(NQ.) (STREET) (CONTR'S LICENSE)
Addition of a porch One Family ome NUMBER OF
PERMIT TO p (_) STORY y DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION)
118 Austin Circle ZONING LRA(N0.) (STREET) DISTRICT le S eV BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Addition
)DWOWIS TO BE 12 FT. WIDE BY 7 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS; permit for an addition of a porch and the moving of window.
VOLUME 84 sq. ft. ESTIMATED COST $ 800.00 FEEMIT $ 10.00
(CUBIC/SQUARE FEET)
OWNER Marianne Berlin
ADDRESS
ustin ira e, Florence BBYILDING DE
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY ^ APPLICANT COPY • PINK ASSESSORS COPY I, I1P