32C-226 (2) ZONING •
FRONT
SIDE YARD SIDE YARD
REAR YARD
IX. SITE OR PLOT
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NOTES and Data — (For department use)
1p— C
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
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 pplica ' n as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signatur a1pl' t Addres Application date
IWAO
0 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
Permit or Approval Check Date Number By Permit or Approval Check Date Number B
Obtained Obtained 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 ,6
Building Use Group
Permit issued 19
Building Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved b�4D
Drain Tile $ 'Z
Plan Review Fee $ ff//
TITLE
CITY OF NORTHAMPTON
�. .� MASSACHUSETTS
$ f OFFICE of the INSPECTOR of BUILDINGS
V T
Paged Plot Ab 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 ` T
I• AT (LOCATION) `�
1 AI II DISTRICT`
LOCATION t� (NO.) (STREET)
OF BETWEEN IJ - ' 6 AND 1,
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vr
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❑ b 12 F-1 One family 18 Amusement, recreational
n Two o
Part D, I3)new housing units added, if any,
in 13 Tr more family - Enter 19 ❑ Church, other religious
-
number of units- - - - --t. 20 ❑ Industrial
3 ® Alteration (See 2 above)
14 ❑ Transient hotel, motel, 21 Parking garage
4 ❑ Repair, replacement or dormitory - Enter number
5 El Wrecking (If multifamily residential, of units ------- - -i 22 Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 L❑ Hospital, institutional
Part D, 13)
16 ❑ Carport 24 Office, bank, professional
6 ❑ Moving (relocation)
17 ❑ Other - Specify 25 ❑ Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8 Private (individua corporation, 28 Tanks, towers
"" 29 ❑ Other - Specify
nonprofit institution, etc.)
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.
7'o be installed but not included If use of existing building is being changed, enter proposed use.
in the above cost pp
a. Electrical....................... I!'L'�✓
b. Plumbing ....................... '
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $
III. SELECTED CHARACTERISTICS OF BOLDING, - 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 y
34 ❑ Other - .Specify 42 Public or private company
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL 1. TYPE OF MECHANICAL 51. Enclosed ......................
35 S Gas Will there be central air 52. Outdoors........................
36X Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 1 Electricity 44 Yes 45-;Z No
�� -. : 53. Number of bedrooms.............. 4;
38 ❑ Coal
39 ❑ Other - Specify Will there be an elevator? Full.......... ..
54. Number of
46 [_� Yes 47�< No bathrooms
Partial.......
DEPT. OF'BUILbING INSPECTIONS
212 Main Street BUILDING oa # /"-2, &-)
Northampton, MA 01060 PERMIT
32C - 226
VALIDATION
June 1 ,
DATE 19 87 323
PERMIT NO.
APPLICANT Phillip B- Wa[ji)Psnark ADDRESS_ 67 Haw]PV 4rPPt QW�r
(NO.) (PIE (CONTR•S LICENSE)
PERMIT TO Alt.Prat.inn (`) STORY_ FX1 Stinn T.In Fam Il.IP11 iQg)WELLRING UNITS
(TYPE Of IMPROVEMENT) N0. PROPOSED USE)P\/ fir
ZONING
HdWl Strppt DIISTR CT IJRC
AT (LOCATION) h7
(NO.) (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: i ng
add dormer
AREA OR
VOLUME 168 sq. ft. attic area ESTIMATED COST .� 2,500.00 FEE $ 12.00
(CUBIC/SQUARE FEET)
OWNER Same as Applicant f�'
t�
ADDRESS I
Same as Applicant's BYL
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY Po,-fp