29-381 (4) Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
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REAR YARD
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NOTES and Data — (For department use)
t)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
1.
Owner or Ow+
Lessee ��,
Builder's
2. t 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.
Sig tur 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 is
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date D
Permit or Approval Check Obta ned 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
Building 9 Use Group
Permit issued ` 19
Building `� Fire Grading
Permit Fee $ ll1 �ry J
Live Loading
Certificate of Occupancy $ Occupanc,K Load
Approved by:
Drain Tile
Plan Review Fee $
TITLE
aCITY OF NORTHAMPTON
9• MASSACHUSETTS
r ;
$ 6 OFFICE of the INSPECTOR of BUILDINGS
�, Page c Plot S�� APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. J/ `yam O ZONING
I• AT (LOCATION) YGj L� I� C-t; (;<; t �-�LJ•Y .•' /�/ a DISTRICT 61
LOCATION — ( (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
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
m
1 E New building Residential Nonresidential
2F__1 Addition(If residential, enter number 1217 One family 18 Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 Two or more family — Enter 19 n 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 ❑ Wrecking (If multifamily residential, of units ——————— — -- 22 Service station, repair garage
enter number of units in building in 15 Garage 23 Hospital, institutional
Part D, 13)
6 � Moving (relocation) 16 ❑ Carport 24� Office, bank, professional
6 Foundation only 1� �
Other — Specify�E 4 25 Public utility
26 School, library, other educational
B. OWNERSHIP f G L:V-N 6� ta C� 27 Stores, mercantile
8 'Private(individual, corporation, 28❑ Tanks, towers
nonprofit institution, etc.) 29 Other — Specify
9 D 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,,,,,,,,,,,,,,,, V 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.
an. the abovabove, �
cost ..� J �; f ( z
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 Public or private company 48. Number of stories..............
31 D 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 Other — Specify 42 F-1 Public or private company 50. Total land ores, sq. Ft. ..........
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed .......................
35 Gas Will there be central air 52. Outdoors........................
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 Yes 45 1! No
53. Number of bedrooms..............
38 Coal
39 Other — Specify Will there be an elevator? Full..........
— 54. Number of
46 [_1 Yes 47 J No in
Partial.......
" ,
VP
DEPrT* ► UILDING INSPECTIONS BUILDING `Q
212 Main Street
Northampton, MA 01060 PERMIT
29 - 381 VALIDATION
DATE May 13, 19 86 PERMIT NO. 239
APPLICANT Cindy Ashton ADDRESS 17 Brookwood Drive, Florence Owner
IND.) (STREET) (CONTR'S LICENSE)
PERMIT TOx)CM Above Ground Pogl I STORY One Family NUMBER OF
DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
Florence
17 Brookwood Drive, ZONING URA
AT (LOCATION) DISTRICT
(NO.) (STREET)
BETWEEN AND
ICROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SMALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: permit for ther installation of an aboveground pool
AREA OR 24')�XXXX dla. 3 200.00 PERMIT 10.00
VOLUME ESTIMATED COST FEE .�
(CUBIC/SQUARE FEET)
OWNER Joseph and Cindy Ashton
ADDRESS 11 xeffM
1 Brookwood Drive, F orence BY1D1
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY APPLICANT COPY • PINK - ASSESSORS COPY pOdp