29-370 (3) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
_I
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN For Applicant Use
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NOTES and'j)ata — (For department use)
�C
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — %'umber, stmt, city, ami .State ZIP code jTel. No.
/
Owner or
Lessee "-
C N Bcenui'der"
2. / f � se No.
L i
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.
Si at re of apph n 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 B Notes
9 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obtained Number By Permit or Approval Check 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 FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued rr-'. c��/ 19 _
Building Fire Grading
Permit Fee $ ,/(1�2 Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITL
o CITY OF NORTHAMPTON
9� MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
'"' Page Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1,.11, 111, IV, and IX. O
IG
I• AT (LOCATION) DIOSTR C/!'
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT _BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D —f
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
M
1 ❑ New building Re ,dential Nonresidential
2 ❑ Addition(If residential, enter number 12: One family 18 ❑ Amusement, recreational
of new bousing 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 E] Parking garage
4 ❑ Repair, replacement or dormitory - Enter number
❑ o units ------- - -► 22 ❑ Service station, repair garage
5 Wrecking (If multifamily residential, f
enter number of units in building in 15 ❑❑ Garage 23 Hospital, institutional
Part D, 13) 16 Carport 24 ❑ Office, bank, professional
6 ❑ Moving (relocation) p
17 Other - Specify 25 ❑ Public utility
7 ❑ Foundation only J 26 ❑ School, library, other educational
B. OWNERSHIP %" f r 27 ❑❑ Stores, mercantile
61 Private (individual, corporation, / /a � L�� /r
28 ❑ Tanks, towers
nonprofit institution, etc.) ,❑Lj i L 2�' �-' 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.
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 $ (�<
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�4 Public or private company 48• Number of stories....../.......
31' Wood frame 41 71 Private (septic tank, etc.) 49• Total square feet of floor area,
JJJJ��� all floors, based on exterior
32 ❑ Structural steel dimensions .....................
33 Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ 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 I. TYPE OF MECHANICAL
35 Lj Gas Will there be central air 52. Outdoors........................
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 [-] Yes 45 No 53. Number of bedrooms...,.',y'�.......
38 Coal
39 Other - Specify Will there be an elevators Full../....
- 54. Number of
46 ) Yes 47* No bathrooms
C- Partial.......
ti
i
INSPECTION RECORD
DATE NOTE PROGRESS - CRITICISMS AND REMARKS - INSPECTOR
tar
t FIELD COPY
., Department of Building, Inspections
212 s street BUILDING
North tunn, Ms. 01060 PERMIT
24 - 370
DATE >tovember 21,E 19_ 80 PERMIT NO. 696
APPLICANT Joan 1K, Brink ADDRESS 37 Austin CirCla- Fla.
(N0.) (STREET) (CONTR'S LICENSE)
OF
PERMIT TO Alteratian I—) STORY Chimna A vood st ye DWELLLRING UNITS #
(TYPE OF IMPROVEMENT) NO. ! (PROPOSED USE)
AT (LOCATION) 3 Austin Circle ZONING
DISTRICT URA
(NO.) (STREET)
m BETWEEN AND
(CROSS STREET) (CROSS STREET)
n LOT
m SUBDIVISION LOT BLOCK SIZE
a
m O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
f
� (TYPE)
° REMARKS: Exterior »asonaly chimney and rood binning stave instal lAtion
AREA OR ♦ t PERMIT
VOLUME ESTIMATED COST .$ 550.00 FEE $ 10.00
(CUBIC/SQUARE FEET)
OWNER _ Ronald A. & jean M_ Brink
ADDRESS 37 Austin Circle' Flare-nee- Ma. n- Q BYILDIr �.✓x .