29-357 (5) Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YARD
REAR YARD
IX. SITE OR PLOT PLAN For Applicant Use
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NOTES and Data — (For department use)
-v
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
'• s" 41D60
owner or
Lessee
i Builder's
1• 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
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
Date D
Permit or Approval Check Obtained Number By Permit or Approval Check Obtta t ed 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
Bui(ding ����} use Group
191
Permit issued _ Ct�C l !(yam
Building W Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
10 am MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page_ Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to,Q complete
J/all items in sections: I, 11, Ill, IV, and IX. O
ZONING
I• AT (LOCATION)r��/ !„L_®vim” DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
V1
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 F__1 New building Residential Nonresidential
2 ❑ Addition(/f 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 El Wrecking Wrecking (If multifamily residential, Of units ——————— — --� 22 L� Service station, repair garage
enter number of units in building in 15 �� Garage 23 n Hospital, institutional
Part D, 13) r
16 C_7 p
Car art 241 Office, bank, professional
6 Moving (relocation)
17 Other — SpeciJyll�� �� � O 25 �� Public utility
7 �� Foundation only
26 School, library, other educational
B. OWNERSHIP 27 L] Stores, mercantile
8 Private (individual, corporation, 28 Tanks, towers
nonprofit institution, etc.) 29 Other — Specify
9 Public (Federal, State, or
local government)
C. COST m:t 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,,,,,,,, FJ ! ? 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.)............. J� _
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 Public or private company 48. Number of stories..............
49. Total square feet
31 Wood frame 41 Private (septic tank, etc.) 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 L__] 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 f Electricity 44 ] Yes 45 No 53. Number of bedrooms..............
38 Coal
39 Other — Specify Will there be an elevatoro Full..........
54. Number of
46 Yes 47 IJ No bathrooms
Partial........
DEPT. WING INSPECTIONS BUILDING z°
212 Main Street
a o
Northampton, MA 01060
PERMIT
29 - 357 VALIDATION
DATE August 19, 19 87 PERMIT NO. 562
APPLICANT AlhPrt. GaQnP ADDRESS 259 Acrebrook Drive Owner
IND.) (STREET) (CONTR'S LICENSE)
PERMIT TO Tn_(;rnll11 �wi ffj0g A,,,,,,,77 NUMBER OF
LL1.�1_) STORY (1nP Family DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
q� ZONING URA
AT (LOCATION) 2rg AcrPhrnnk Drl VP DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
MW IS TO BE _ i6 FT. WIDE BY 32 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
I
REMARKS:
high fence with a self locking gate
AREA VOLUME 512XOO sq. ft. ESTtMATEO COST ,� 10, 115.00 PERMIT $ 10.00
(CUBIC/SQUARE FEET) `
C JJ
OWNER Same as A licant +r��� fy
ADDRESS Same as Applicant's :Y 1
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY ■ PINK - ASSESSORS COPY Alk
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