29-439 (6) ZONING •
DISTRICT
FRONT YARD
Ix. SITE OR PLOT
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, 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 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 By Notes
Fee Started y Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or A rovaI Check Date Number B Permit or Approval Check Date Number pp Obtained y pp b By
y
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 �i %� FOR DEPARTMENT USE ONLY
Permit number IL� 11
Building �` r Use Group
Permit issued 19 TT Building �` Fire Grading
Permit Fee $ w
Live Loading
Certificate of Occupancy $ Occupancy Load
Drain Tile $
Approved b�y�:,�
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�. .� -40 90 MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
♦u t
Page Plot �41�g 1 APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
Syjj ZONING
F l }�n
I• AT (LOCATION) (y't.� I•w� .y"Y"Yt�.rs.� I-�C.7 r) DISTRICT
LOCATION (N ') (STREET}'
OF BETWEEN AND
BUILDING CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
to
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 Re 'd ntial Nonresidential
2 ❑ Addition()/ residential, enter number 12 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 � (See 2 above)� 14 ❑ Transient hotel, motel, 21 �� Parking garage
4 epair, replacement or dormitory — Enter number
5 ❑ Wrecking (1l multifamily residential, of units ——————— — -i 22 L� Service station, repair garage
enter number of units in building in 15 Garage 23 Hospital, institutional
Part D, 13) 16 Carport �❑ Office, bank, professional
6 ❑ Moving (relocation)
17 ❑1� Other — Specify j�ac V, 25 Public utility
7 ❑ Foundation only
26 School, library, other educational
B. OWNERSHIP JuC r.r\ ' rtll'1tr2C} 27 L❑ Stores, mercantile
8 l" 1 Private (individual, corporation, ( i f 28 ❑ Tanks, towers
nonprofit institution, etc.) 1 '( ,' 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
''i'i, processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,,,•,,,,,•,.., t ` .' �'� 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 is 1 ( c C'
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 C] 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
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 1. TYPE OF MECHANICAL
35 ❑ Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 ❑ Yes 45 1 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevators Full..........
— 54. Number of
46 [--1 Yes 47 '❑ No bathrooms
Partial.......
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''4w
DEPT. (V BUILDING INSPECTIONS
BUILDING
z
014
I a.
**44w212 Main Street
Northampton, MA 01060 1 PERMIT
29 4219, VALIDATION
June 2P,
IrlIT r
aime S & Michelle nT1-ay RE55 r r,r rn-97) n "0. orence Owners
APPLICANT ADDRESS (NO.) (STREET) (COWTR'S LICENSE)
NUMBER OF
PERMIT TO Al t era t-ion STORY Existing Pool DWELLING UNITS
(TYPE Of IMPROVEMENT) NO. (PROPOSED USE)_
67 Ellington Road, Florence ZONING URA
AT (LOCATION) (NO.) (STREET) DISTRIC
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
Px%v1SUBDIVISION LOT-BLOCK SIZE
ME IS C K TO BE FT. WIDE BY 14
Y FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
xx
TO TYPE USE GROUP -BASEMENT WALLS OR FOUNDATION ITYPE)
REMARKS: permit for the construction of a dock around existing above around pool
112 sq. ft. 700.Ou" PERMIT $ 10.100
AREA OR ESTIMATED COST $ FEE
VOLUME
(CUBIC/,SQUARE FEET)
OWNER cane as Applicants UILD) 6:,.IvtPT
Saffle as Applieant's
ADDRESS :Y Q 4sa
IV
WHITE FILE COPY s GREEN FIELD COPY CANARY - APPLICANT COPY • PINK - ASSESSORS COPY PiRT P
e DEPT BUILDING INSPECTIONS BUILDING ZO
DEW 212 Main Street O<
Northampton, MA 01060 PERMIT a.
29 - 439 VALIDATION
June 29, 88 410
APPLICANT
James & Michelle F�inl ADDRESS ing on�RRcI; I 'orence wners
IND.) (STREET) (CONTR•S LICENSE)
Alteration Existin g Pool NUMBER OF
PERMIT TO (_1 STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
El I ington Road Florence ZONING URA
AT (LOCATION) ° DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
DECK
XxWXWXIX IS TO BE 8 FT. WIDE BY 14 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS, permit for the construction of a deck around existing above ground pool
AREA OR
112 sq. ft. 700.00 PERMIT 10.00
VOLUME ESTIMATED COST $ FEE
(CUBIC/SOUARE FEET)
Same as Applicants
OWNER Same as Appiieent's
ADDRESS BY
I P
L `y u
WHITE — FILE COPY . GREEN — FIELD COPY ■ CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pjNf I�P