32C-316 (3) Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YARD
SIDE YARD SIDE 'D
REAR YARD
NOTES _-V
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NOTES and Data — (For department use)
eol
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city. and State ZIP code Tel. No.
Owner or . . .1.. .__.. ..
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
o � ,
00 NOT WRITE B' LOW THIS L NE
V. PLAN REVIEW RECORD — For office use
Plans Review Re wired Check Plan Review Date Plans By Plans B Notes
9 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
ate Date
Permit or Approval Check ObDtained Number By Permit or Approval Check 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 L' j FOR DEPARTMENT USE ONLY
Permit number /(
Building. \ Use Group
Permit issued 19 T
Building Fire Grading
Permit Fee
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $ ,?
T I T L`E—`
CITY OF NORTHAMPTON
9� 4 MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page } Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT — Applicant to comp le��ette all items in sections: 1, 11, 111, IV, and IX. O
ZONING
I• AT (LOCATION) /-�' / "j DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
to
II. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
M
1 ❑ New building Rekidential Nonresidential
2 ❑ Addition(If residential, enter number 12,�?5One 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,
4 Repair, replacement ❑ or dormitory – Enter number 21 ❑ Parking garage
3�`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)
17 J Other – Specify 25 ❑ Public utility
7 ❑ Foundation only /
26 ❑ School, library, other educational
B. OWNERSHIP ) —�^ `''� T� �_% 27 ❑ Stores, mercantile
A 28 ❑ Tanks, towers
8 ❑ Private (individual, corporation, ❑29 Other – S p eci fy
nonprofit institution, etc.) �f i
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, secondar y 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 I$ �L+
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 1,0 Masonry (wall bearing) 40 ❑ Public or private company 48. Number of stories..............
31 Wood Frame 41 ❑ Private (septic tan tc,} 49• Total square feet of floor area,
all floors, based n 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
4,,Z,. 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? 7 i-� L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity y ;,rte/ 44 ❑ Yes 45 L J No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other – Specify Will there be an elevator? Full..........
54. Number of
46 [_] Yes 47 ❑ No bathrooms
Partial.......
Department of Building Inspections
212 fain Street BUILDING Zo
Northampton, Ma. 01060 . _ PERMIT Ma I (J�J
a
32C - 316
VALIDATION
DATE September 16, 19-82 PERMIT NO. 451
APPLICANT Hpt Pn 591 ps'nck? ADDRESS 40 Henry
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO rep�air�-T8^LSCL (� _) STORY two car Qarat�e DWELLING UNITS 1
TYPE OF IMP�OYEMENT) NO. ( ROPOS D USE)
ZONING
AT (LOCATION) 40 He>erf DISTRICT. UC
(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: Rep air X x(�rpl acg_aarage (detached) .74' X 22'
AREA OR PERMIT
VOLUME ESTIMATED COST $-3,08 FEE I2 nn
(CUBIC/SQUARE FEET)
OWNER Helen Slesinski rr
Northam 01060 BULL NG PT.
ADDRESS 40 Henry Street, Northampton, Ma. BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT C PINK - ASSESSORS COPY