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29-221 (6) ZONING • DISTRICT FRONT YARD SIDE YARD SIDE - . REAR YARD NOTES IX. 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IDENTIFICATION — To be completed by all applicants Name Mailing address — Number, street, city, and State ZIP code Tel. No. Owner or � Lessee 17 e/ Builder's (P 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 ApplicatioAdate, / 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 $ ELECTRICAL $ OTHER is VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Date Permit or Approval Check Obta ned Number By Permit or Approval Check Date 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 VII. VALIDATION Building FOR DEPARTMENT USE ONLY Permit number �3 Bul[ding. Use Group Permit issued 3a 19 Building Fire Grading Permit Fee $ t�t� Live Loading Certificate of Occupancy $ Otto ancy d A r Drain Tile $ Plan Review Fee $ TITLE CITY OF NORTHAMPTON 9* *� MASSACHUSETTS $ e OFFICE of the INSPECTOR of BUILDINGS "T Page 0197 Plot r APPLICATION FOR ZONING PERMIT AND INSPECTOR BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. 0 a' yv, ZONING I• AT (LOCATION) i_-�f�./JDISTRICT 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 A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m m 1 ❑ New building Reside tial 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 3 Alteration (See 2 above) number of units— — — — -� 20 ❑ Industrial ❑ 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) 16 ❑ Carport 24 Office, bank, professional 6 [ Moving (relocation) i1 D ❑ 17� Other — Specify ��� � 25 Public utility 7 n Foundation only 26 School, library, other educational B. OWNERSHIP 144-7 27 [ Stores, mercantile 8 X Private (individual, corporation, rf / A / 28 Tanks, towers nonprofit institution, etc.) �Z/7 Ile 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 $ of ,Iv 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 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 WATER SUPPLY 34 �� Other p /y 42 Public or private company 50. Total land area, sq. ft. .......... — S eci 43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed ....................... F. PRIPAL TYPE OF HEATING FUEL I. PE OF MECHANICAL 35 Gas Will ere be central air 52. Outdoors....................... conditio ing? 36 [ � Oil _ L. RESIDENTIAL BUILDINGS ONLY 37 [ f Electricity 44 L Yes 45 [I No 53. Number of bedrooms.............. 38 ❑ Coal 39,X Other — Specify / Will there e an elevot Full.......... //// 54. Number of 46 es 47 [, No bathrooms Partial........ w , Ao DeparMeRn "5f Building Inspections 212 Main Street BUILDING z° Northampton, Ma. 01060 PERMIT a O< 29 - 221 �.. � VALIDATION DATE_April IQ- 19 82_ PERMIT NO. 155 APPLICANT atricia G Hathaway _ ADDRESS 112 Acrehrook Dr., Flo. _ (NO.) (STREET) (CONTR'S LICENSE) NUMBER OF PERMIT TO AdAi Linn (1_) STORY EnclpcPd set ar etch DWELLING UNITS 1 _ (TYPE OF IMPROVEMENT) NO. (PROPOSED USE ZONING �A AT (LOCATION) 112 ArrPhreek Drive DISTRICT (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE Porch 0L%=7IS TO BE 10 FT. WIDE BY 23 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: Addition of solar JUMIMU enclosed porch - glass in front, wood on sides AREA OR ESTIMATED COST $ ��O�O FEEMIT �P p 2 VOLUME (CUBIC/SQUARE FEET) a OWNER BUI P ADDRESS BY 4 /� - WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK ASSESSORS COPY