29-269 (5) ZONING •
FRONT DISTRICT
SIDE YARD SIDE • .
IX. SITE OR • Applicant
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NOTES and 'Data — (For deportment use)
IV. IDENTIFICATION — To be completed by all applicants
A nNome Mailing address — Number, street, city, and State Z)P 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
D0 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
Date D
Permit or Approva I Check Obtained Number By Permit or Approval Check Obtta tned 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
II. VALIDATION
Building / FOR DEPARTMENT USE ONLY
Permit number
Building• Use Group
Permit issued � �� 19
Building ( Fire Grading
Permit Fee $ Loading
Certificate of Occupancy $ Occupancy Lo
pprove by:
Drain Tile $
Plan Review Fee $
TITLE
O O ' CITY OF NORTHAMPTON
MASSACHUSETTS
�b OFFICE of the INSPECTOR of BUILDINGS
' Page Plot C '` Co
APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING(��/
I• AT (LOCATION) DISTRICT
LOCATION (N0•) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vf
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D -i
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use M
M
1 New building Residential Nonresidential
2 Addition(I/ residential, enter number
( ( 12 One family 18 Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 Two or more fomily — Enter 19 Church, other religious
number of units— — — — --)o. 20 Industrial
3 �' Alteration (Sec: 2 above) 14 Transient hotel, motel,
21 Parking garage
4 D Repair, replacement or dormitory — Enter number
5 El (I multifamily residential, of units --—————— — --). 22 Service station, repair garage
Wrecking l f Y
enter number of units in building in 15 Garage 23 Hospital, institutional
Part D, ]3)
16 Carport 24 Office, bank, professional
6 Moving (relocation)
17 Other — SpeciJy 25 E] Public utility
7 n Foundation only
26 C] School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
B Private (individual, corporation,
28 Tanks, towers
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,,,,,,,,,,,,,,,, o 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 l7�-�jLJ
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 O 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 C� Reinforced concrete H. TYPE OF WATER SUPPLY
34 Other — Specify 42 Public or private company 50. Total land area, sq. ft. ...........
43 L7 Private (weil, cistern) K NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MEZa
35 �f Gas Will there be c52. Outdoors.......................
36 Oil ditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 4 L 53. Number of bedrooms..............
38 Coal
39 l—] Other — Specify ll there a a Full...`
54. Number of
46 Yes 471 No bathrooms Partial........
INSPECTION RECORD ! .�
DATE NOTE PROGRESS - CRITICISMS AND REMARKS INSPECTOR
7 ,
F
FIELD COPY
ftp OF NInDIMc nNsPIECTIONS BUILDING I# Jj 311a
2 11.I�i
1'x..,
Kt►. 01064 PERMIT
29 - 259
DATE November 4• 19 SU PERMIT NO. 501
APPLICANT 1Cnr@II 21- Bostack ADDRESS 45 Lctgview Dr., 1(1;ton.
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO �� L stove (�) STORY For WAQd-burning stove
DWELLING UNITS
(TYPE 0 IMPROVEMENT) +,� NO. (PROPOSED USE)
ZONING U�
AT (LOCATION) 45 _=�Myiew Drive DISTRICT
(N0,) i i(STREET)
rn BETWEEN AND
e .(CROSS TR T) (CROSS STREET)
rn
LOT
SUBDIVISION LOT BLOCK SIZE
m
a "\ 1 i
p BUILDING IS TO BE ,`7\ ADE Bt T, LONG BY FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION C
m 4 / I
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
� (TYPE)
K
LL O REMARKS: view black cbimney for existing woad-burning stove
AREA PERMIT
VOLUME ESTIMATED COST $ 200.00 E O 0
(CUBIC/SQUARE FEET)
OWNER y'leYf 7 Rost-*-%r B
ADDRESS _>45 I ;ew px -i Martha=tan-_M$. 01060