29-365 (3) ZONING r
DISTRICT
1
FRONT
SIDE YARD SIDE - .
REAR YARD
NOTES
IX. SITE OR PLOT
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NOTES and Data — (For department use)
Jl
IV. IDENTIFICATION — To be completed by all applicants
Name CL CI Mailing address — Number, stmt, city, and State 22IP code el.�No.
Owner or
Lessee
Builder's
2. License No.
Contractor
}
3.
A
Ff 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 B Notes
9 Fee Started y Approved y
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
But Iding Use Group
Permit issued _ 19 _
Building Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TlYtE
o� CITY OF NORTHAMPTON
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
�j/, ZONING
I• AT (LOCATION) 72 U ///� �I�C��� DISTRICT
LOCATION (N0.) (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
--f
1 ❑ New building Residential Nonresidential
2X Addition(If residential, enter number 12M 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,V Repair, replacement or dormitory — Enter number
5 Wrecking (it multifamily residential, of units ——————— — -� 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) p
17 Other — Specify 25 ❑ Public utility
7 ❑ Foundation only �y16 ❑ School, library, other educational
B. OWNERSHIP � 7 ❑� Stores, mercantile
8 Private (individual, corporation, �/ 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 ❑ Other — Specify
9 ❑ Public (Federal, State, or cyy
local government) � -tom '.5"
C. COST (0 it cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food
eo� b processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement• ,�/� �r,7, 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�X Public or private company
48. Number of stories../...........
,)e Wood frame 41 ❑ Private (septic tank, etc.) 49• Total square feet of floor area,
CG//r all floors, based of x er �yt
32 ❑ Structural steel dimensions ..../ / nJ
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other — Specify 42_54 Public or private company
50. Total land area, sq. ft. ...........
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed ..... -L �
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 �❑ Gas Will there be central air 52. Outdoors........................
36 Oil conditioning?
_ �—J� L. RESIDENTIAL BUILDINGS ONLY
L
3 Electricity 44 Yes 45X No 53. Number of bedrooms..............
388 Coal �\
39,�Other — Specif Will there be an elevator? Full..........
���� 54. Number of
46 ❑ Yes 47 No bathrooms
7`C Partial.......
:: , ,_,.
�� ,.���
,. p R
' c �;
® C -. ..
Depprtment of Building Inspections
� s.t BUILDING 0< d, ` /�,�o
Northampton, Ma. 01060 PERMIT a
27 365 VALIDATION
DATE May 17, 19 87 PERMIT N0. 199
APPLICANT ATPnAA Ni Pd2Xi Pcki ADDRESS_ 79 Austin Circle
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO �- �ltaA- AAdi ti nn (�-1 STORY DWELLING UNITS 1
1 PE OF IM ROVEMENT) NO. PROPOSED USE)
ZONING ��
AT (LOCATION) 79 Austin Circle DISTRICT
(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: Addition to kitchen• 1()l X 70' Rpn1ArP PXicting Above ground swimming pool
with new one, 24' X 4' round; replace storage shed with one 8' X 10'.
VOLUME ESTIMATED COST $ inn FEEMIT 16.00
(CUBIC/SQUARE FEET)
OWNER BT ndA Niediwipe-ki BUILDIN DEP
ADDRESS 79 Austin it le, Florence, Ma 01,060 BY
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPT INK - ASSESSORS COPY