35-005 (24) VIII. ZONING PLAN EXAMINERS NOTES
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REAR YARD
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — .A'urril>ei, st�r�1, rite, rrrrr/ ltutr• ZIP code Tel. No.
Owner or / .a,- 1 �" t,/ d AA,1_1110io" oJ C 0,4�^i(. V ti n1
Lessee f'
�j _ Builders
1 "ter y•
Contractor License No.
Rd
3. sly si ,6
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 o conform to all applicable laws of this jurisdiction.
Signature of lic Address,���� Application date
4rv4r4.t '
0 NOT WRIT LOW THIS L
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans
Fee Started Y Approved By Notes
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER
Vi. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check
Date Number B Permit or Approval Check Date umber B
Obtained Y pp Number Y
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
Permit number ASY
Building
Permit issued � ! 19
Building
Permit Fee
Certificate of Occupancy S
Approved by:
Drain Tile
Plan Review Fee $_
TITLE
ti`e (sixty of Xort4ampton
� � �Irlssncllltsetts
Offzre of the Ynspertar of 39uilbiltgs APPLICATION FOR
PagePiot C ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, III, IV, and IX. p
ZONING
I• AT (LOCATION) f (-.�'� • F," V / l lf&. � DISTRICT
LOCATION (NO.) (S REET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
f�
11. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" ost recent use m
9' m
1 X New building Residential Nonresidential
2 ❑ Addition(1/ 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) ❑
6 ❑ Moving (relocation) 16 Carport 24❑ Office, bank, professional
7 ❑ Foundation only 17 ❑ Other - Specify 25 ❑ Public utility
26❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8 X 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
[' —00 processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement•,••,,,,•,,,•,,• J 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 1
a. Electrical..................... �f, /l . .4'l t 1., _
b. Plumbing .....................
c. Heating, air conditioning.........
d. Other (elevator, etc.)............
ii. 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 1V. y
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS M
m
30[-]Masonry (wall bearing) 40 ❑ Public or private company 48• Number of stories..............
31 I-Wood frame 41X Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32❑ Structural steel dimensions .....................
33 Reiodoceed concrete H. TYPE OF WATER SUPPLY
34❑ Other - Specify 42 ❑ Public or private company 50. Total land area, sq. ft. .........,.
43JX Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES 1 10
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ....................... 0
35 ❑ Gos Will there be central air 52. Outdoors........................
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44❑ Yes 45 54 No 53, Number of bedrooms..............
38 ❑ Coal
39 ❑ Other - Specify Will there be an elevator? 54. Number of Full..........
46❑ Yes 47 ANo bathrooms
Partial........
I hereby certify that the proposed work is authorized by the ownet'of record
and 1 have been authorized by the owner to"make this application as his
authorized agent.
e
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 1g
• ;j f
DEPT. FILE COPY
CITY OF NORTHAMPTON ;0
BUILDING as
NORTHAMPTON. Mk, 0060 35-5 PERMIT
VALIDATION
DATE y 8. 1978 PERMIT NO. 159
APPLICANT Antbany t-q,fan ADDRESS 88 Turkey Hill Rd.
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO S'tnMAftA C'rA7�8,�18 (_) STORY +(nTagem *AT�ApB _—DWELLING UNITS
(TYP OF IMPROV ME NT) NO. (PROPOSE USE)
ZONING
AT (LOCATION) =key. 4i11 Road - DISTRICT BB
(NO.) (STREET)
a BETWEEN AND----
v (CROSS STREET) (CROSS STREET)
W
LOT
a SUBDIVISION LOT BLOCK SIZE
ro
p BUILDING IS TO BE FT. WIDE BY 3-6 _FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
ED
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
� (TYPE)
B:
L- REMARKS: — Construct 3 Bu Stw .. rWe C7a°@,ge
AREA OR PER MIT
VOLUME 1o8o so, ft. ESTIMATED COST FEE $ 15.00
(CUBIC/SQUARE FEET)
OWNER Ant=y T)nnald & IVES[+}19.01 Stpfan - BUI D G DEPT
ADDRESS Aq %Nl key M 1 1 Rd. ._ N'tfon B
(Affidavit on reverse side of application to be completed by authorized agent of owner)