29-390 (6) vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
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SIDE YARD SIDE YARD
REAR YARD
NOTES
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NOTES and Data — (For department use)
IV. IDENTIFICATION - To be completed by all applicants
Namefj� Mailing address — Number, stmt, city, and State ZIP code ^�Tel. No.
Owner or
Lessee
Ofo4'Q
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 application as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature of applicant Address Application date
D0 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
Fee Started y Approved y
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
Building Use Group `
Permit issued (J( �� 19
Building Fire Grading
Permit Fee $ 7.2. o d
Live Loading
Certificate of Occupancy $ Occupancy Load
Drain Tile $ Appr by:
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
$ OFFICE of tth INSPECTOR of BUILDINGS
390
Page °` Plot �
APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, lll, IV, and IX. 0
Y C�/� E+�B �/Z[ ZONING
�J
AT (LOCATION) DISTRIC
LOCATION (NO.) (STREET)
OF BETWEEN �C• 4 iw a ro/V AND C AC– 7- W
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D ;0
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use rn
rn
-4
1 New building Residential Nonresidential
2 Addition(1/ 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 n Church, other religious
number of units– – – – 20 Industrial
3 Alteration (.See 2 above)
lei Transient hotel, mote l, 21 21 Parking garage
4 Repair, replacement or dormitory – Enter number .
5 I Wrecking (lf multifamily residential, �
Of units -------- – -i 22 �� Service station, repair garage
enter number of units in building in 15 F___ Garage 23 L 1 Hospital, institutional
Part D, 131 L–� 9 _
16 24 E� Office, bank, professional
D Carport
6 D Moving (relocation)
17 � Other – Specify _ 25 �_� Public utility
7 Foundation only J
t–� y 26 � � School, library, other educational
B. OWNERSHIP u JL 27 j Stores, mercantile
8 Fi-<Privote (individual, corporation, (` 28 j Tanks, towers
nonprofit institution, etc.) 29 Other – .Specify
9 L 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................ X00 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....................... ! 0 v O
b. Plumbing ...... o 0
................•
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $ 0 U�
III. SELECTED CHARACTERISTICS OF BUIL ING — 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
48. Number of stories...............
30 L] Masonry (wall bearing) 40 i,�Public or private company
49. Total square feet of floor area, bl
31 Wood frame 41 1 1 Private (septic tank, etc.) all floors, based on exterior
32[ JI Structural steel — dimensions .....................
33[7i Reinforced concrete H. TYPE OF WATER SUPPLY
r 50. Total land area, sq. ft. ...........
34 Other – .Specify 42 [ Public or private company
43 j–,! 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........................ t f
36 L� Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 _r Yes 45 _!/. No 53. Number of bedrooms..............
38 �1, Coal
39�� Other – 54. Number of
Specify Will there be an elevators Full.......... 1
--
46 Yes 47 !�o bathrooms
Partial.......
. OF BUILDING INSPECTIONS BUILDING Z°
212 Main Street '`<���"���.
Northampton, MA 01060 PERMIT Q a
29 - 390 VALIDATION
DATE -Oct. 22, 9 ,�8$ PER IT NO._ 3
APPLICANT James Martin ADDRESS �� oiTrtn-Farms �d. wne
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO Addition (`) STORY One Family DWELLRING OF
UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 66 Brookwood Drive DISTRICT
CT
I 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; permit to add second story onto existing single family dwelling, for extra living space
AREA VOLUME 864 sq. ft. ESTIMATED COST $ 19,800.00 FEEMIT 172.00
(CUBIC/SQUARE FEET)
OWNER Same as Applicant / ( t ��
BUILOfN� �P �4-
ADDRESS Same as Aprnl i rant' S BY GG
WHITE - FILE COPY . GREEN - FIELD COPY CANARY - APPLICANT COPY • PINK - ASSESSORS COPY p}NT p