29-200 (3) V111. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
s I vF i d 1
t P e 1 s'. dc t # � p -w#: r 'y
'i r
a # d + t r x i . r tl
.c
«v g d# i 4 f +
3 § r
#d +-� fi°t--; i , 1j,
$' r s
+
t 7 r# ..
14 2 ry
4
_ d i
rt#JU+ s +
iTi
F bey
#- # +-`Id, d
s
T
t
s 8 a ' S rJd Pa
#.�
d --p
°P #+ t -rS�+ y�q. ` a3 yy.z._ ter s {�+s� �1 y.'. ° Ip'f.l�.
Nz
44 4 f A r4
P rt- ..
+1 fi-.i .* -*--#-a -6 ^F "`'° "rv�59mw a Yt�-SY P p... p
Tex `f
y.-t I T {+ t `r f°
# �` t x
.r 'p
d¢ '3:: ```d +' a ', 7 t -(
a
&F i 4
i
d-`ter e;+I f a; 4 i
a f, 4 t r.d a�s t-# §s- 41-1-H
�1 f f'4 y d id-+s-+f t w €-t T}a r
it 1 "_'r" 5 1. r> -' +
'
?i. �- z -+�`
R d a T r. #- 4 k 7 # �'.`�. -e-
��
+ 7 s d rra
r
;. a .�- L,.a d#: #-m' '§"-d -;%#r-m --#a # ! k-s ad dt ...{--a .5-;
`� �{ dJ. IY
d L 9"'g.", �. "i
a t 3+,
d,
�g - t- a c a� g
ii, i i
p-1 "� o-'
i r
aA{` r' r
{ r-F;€ # x r s s s 9
c #.-b - .+ ^. -p
t .dF 4 2i ( + + 5 3£ pf C 1 t 01
a v f i * Y5_§� --g'r-a#$b i �e� o- + d ,� "+ t� ¢!. =da` afr cam.,
r:
' $ S Ply ' # t
i
t
_ tt rZ
5 A
.. � �, .s, .,_.... ..... �. . �&.._a a., ..fie .
BOCA FORM APEBP — 669 C1969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
131. IDENTIFICATION — To be completed by al! applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
r
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
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plan Review Date Plans B Date Plans
Plans Review Required Check Fee Started y Approved BY Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or A l Check Date Number By Permit or Approval Check Date Number By
PP roya Obtained Obtained
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
Bui Iding Use Group
Permit issued T 19- —
Fire Grading
Building
Permit Fee $ Live Loading
Occupancy Load
Certificate of Occupancy $
Ap e by: I
Drain Tile
Plan Review Fee $ �,
TITLE
• 4
NOTES and Data — (For department use)
CITY OF NORTHAMPTON �//
OFFICE OF THE INSPECTOR OF BUILDIN&
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 PLAN EXAMINATION AND
BUILDING PERMIT
z
IMPORTANT/—/�Applicant to complete all items in sections: 1, It, 111, IV, and IX.
T ( 62111r—ry �/,eon/'r 'OR ZONING�! I?
I• AT (LOCATION)
LOCATION (NO') (STREET) DISTRIC
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
H
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
—1
1 dNew building Residential Nonresidential
2 ❑ Addition(If 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 ❑ 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) 16 ❑ Carport 24 Office, bank, professional
6 ❑ Moving (relocation) 25 ❑ Public utility
17� Other — Specify
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
28 ❑ Tanks, towers
8 dPrivate(individual, corporation,
nonprofit institution, etc.) 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................ �� �C 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 !Gy
48. Number of stories...............
30❑Masonry (wall bearing) 40 Public or private company
49. Total square feet of floor area,
31 ® Wood frame 41 Private (septic tank, etc.) all floors, based on exterior
32❑ Structural steel dimensions .....................
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
42 Public or private company 50. Total land ores, sq. ft. ...........
34❑ Other — Specify � p
43 ❑ 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........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 VElectricity 44 ❑ Yes 45 ❑ No 53. Number of bedrooms..............
38 [—] Coal
39 ❑ Other — Specify Will there be an elevator? 54. Number of Full..........
46 [:] Yes 47[:] No bathrooms Partial........
I hereby certify that the proposed work is authorized by the owner of record
and I have been authorized by the owner to make this appticafirfn as. h.is
authorized agent.
SIGNATURE OF AGENT`
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
DEPT. FILE COPY
' CITY OF NORTHAMPTON BUILDING 0 a
NORTHAMPTON, MA. 29-200 PERMIT VALIDATION
DATE June 27, 19 78 PERMIT NO. 2.56
APPLICANT Robert L?Blanc ADDRESS 47 Overlook Drive
(NO.) (STREET). (CONTR'S LICENSE)
PERMIT TO ghee �r377X� � NUMBER OF
(��) STORY rdP.rn AhP.C3 DWELLING UNITS
(TYPE OF IMPROVEMdNT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) 47 Overlook Drive DISTRICT URA
(NO.) (STREET)
a BETWEEN AND
ro (CROSS STREET) (CROSS STREET)
IL LOT
m SUBDIVISION LOT BLOCK SIZE
a
0 BUILDING IS TO BE 8 FT. WIDE BY 10 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
CD
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
Lo REMARKS: _ Construct aux, shed for garden supplies
AREA OR p�, PER MIT
VOLUME RD ESTIMATED COST $ 200.00 FEE $ 10.00
(CUBIC/SQUARE FEET)
OWNER Robert LeBlanc
B
ADDRESS 47 Qmrarl n(-Lk TTni prat TAT I i;nTt
(Affidavit on reverse side of application to be completed by authorized agen Jfowner)