29-286 (7) Vill. ZONING PLAN EXAMINERS NOTES
FRONT YARD
SIDE YARD SIDE YARD
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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 +or'j I—��S /� Q �it1 C05 L l �An �` �� /
Lessee PrAre(cI$ .J, 0000j Q �'4 O� f_If4✓Cs• 016 1X1 V16(�L-)
Builder's
2. SA l; License No.
Contractor
s.
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 9p plicant Address Application date
i
�a Pie�NCASR(- 73
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans g Notes
9 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Permit or Approval Check Obtained Number By Permit or Approval Check Obttatned 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 V
Building � Use Group
Permit issued 19 S1
Building Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $ `�
r°
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�• MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
k t
Page �r Plot1�a APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT— Applicant to complete all items in sections: 1, 11, lll, IV, and IX. O
pE/J fA S � ZONING
I• AT (LOCATION) DISTRICT
V (�
LOCATION 1N0.1 (STREET)
OF BETWEEN �R L^/GG H570)5- C�RCL E 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 F-1 New building Resid A tial Nonresidential
2 Addition(If residential, enter number 12 One family 18 Amusement, recreational
of new housing units added, if any, 13 Two or more family — Enter 19 Church, other religious
in Part D, 13)
number of units— — — — 20 Industrial
3 n/>Iteration (See 2 above) _
rL—I!'�1( 14 � Transient hotel, motel, 21 �_� Parking garage
4 Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (If multi family 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)
7 Foundation only 17 ❑ Other — Specify 25 Public utility
26 School, library, other educational
B. OWN RSHIP 27 Stores, mercantile
8 Private (individual, corporation, 28 Tanks, towers
nonprofit institution, etc.) 29 Other — Specify
9 D Public (Federal, State, or
local government)
C. COST (iit 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,,•,,,•,,,••,.,• L school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office building at industrial plant.
7'o be installed but not included If use of existing building is being changed, enter proposed use.
in the above cost
a. Electrical.......................
b. Plumbing ....................... 6jo
c. Heating, air conditioning.......... NU
d. Other (elevator, etc.)............. AjQ
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 `
30 Masonry (wall bearing) 40 [-] Public or private company 48. Number of stories.............. t
31 VWood frame 41 Private (septic tank, etc.) 49. Total square feet of floor area,
--� all floors, based on exterior 1
32 [::] Structural steel dimensions ..................... /d X /0
33 E] Reinforced concrete H. TYPE OF WATER SUPPLY
34 D 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 I. TYPE OF MECHANICAL
35 Gas Will there be central air 52. Outdoors........................ NO
conditionig?n
36 � Oil L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 n Yes 45 No 53. Number of bedrooms..............
38 Coal h , �)
39 Other — Specify NO NC Will there be an elevators i/
54. Number of )
46 [_� Yes 47 1 No bathrooms '✓
Partial.......
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