29-216 141 ACREBROOK DR MISIDENTIFIED AS 28-216 VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE (
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
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BOCA FORM APEBP - 669 01969 BUILDING OFFICIALS & CODE ADMINISTRATORS I�E TIONAL, INC.
IV. IDENTIFICATION — To be completed by all applicants
Name j Mailing address — Number, strcet, /city, and State ZIP code Tell. No.
JOwner or ( ✓ �� / /G. C� ` ��� /(ACA j (6'��
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 licant Address o 1 Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obta ned 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 FOR DEPARTMENT USE ONLY
Permit number �r
Building `�/ Use Group
Permit issued 'y 19_,_
Building Fire Grading
Permit Fee $ Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $ J
TIT E
NOTES and Data — (For department use)
L
P �
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET _ APPLICATION FOR
NORTHAMPTON, MA. 01060 PLAN EXAMINATION AND
BUILDING PERMIT
z
I• IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX.
O
ZONING
AT (LOCATION) / e ee&M O/ 12 ? s DISTRICT
LOCATION (NO.) (STR T) AND -4---mi '
/ ' 1 OF BETWEEN 6 � „ \ �/
BUILDING 7 (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
V1
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 ❑ New building Residential Nonresidential
20 Addition(If residential, enter number 12;K 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,
4 ❑ Repair, replacement or dormitory - Enter number 21 ❑ Parking garage
5 F-1 Wrecking (If multifamily residential, of units ------- - -i 22 E] Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional
Part D, 13) ❑
16 Carport 24❑ Office, book, professional
6 ❑ Moving (relocation)
17❑ Other - Specify 25 ❑ Public utility
7 ❑ Foundation only l�
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8 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................ / if t 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 $ V L
III. SELECTED CHARACTERISTICS OF B ILDING — 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) 400 Public or private company 48• Number of stories................
3 ; Wood frame 41 ❑ Private (septic tank, etc.) �• Total square feet all floors, based on floor area, _
/�" exterior
32❑ Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 F-1 Other - Specify 42� Public or private company 50. Total land area, sq. ft. ...........
43 ❑❑j Private (well, cistern) K. NUMBER OF OFF-STREET
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? L. RESIDENTIAL BUILDINGS ONLY
37�K Electricity 44 ❑ Yes 45Ankl No 53. Number of bedrooms..............
38 u Coal
39❑ Other- Specify Will there be an elevator? 54. Number of Full..........
46 ❑ Yes 471K 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 application as his
authorized agent.
SIGNATURE 'OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
Z❑
DEPT. FILE COPY
....,.�,� BUILDING
DEPT.OF BUILDING lNSPEC'TlQNS PERMIT 212 Main Sbvd VALIDATION
No�rnom A kft 010M 28-216
DATE October 31, 19 78 PERMIT NO, 543
APPLICANT_ N$TlcV Baby&ZS ADDRESS 141 Aerehrnen Drive
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO Addition (1) STORY 't=orch DWELLLRING OF
UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 141 Acrebrook Drive ZONING
DISTRICT
(NO.) (STREET)
w BETWEEN Beatty Drive AND Gilrain Terrace
1O (CROSS STREET) (CROSS STREET)
IL LOT
w
M SUBDIVISION LOT BLOCK SIZE
M
a Addition
0 IS TO BE 16 FT. WIDE BY a1 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
I
Ir (TYPE)
o REMARKS: Add over exiatini deck an 11 X 16 M=areh
AREA OR VOLUME ESTIMATED COST $ PERMIT
VOLUME 1 .00
(CUBIC/SQUARE FEET)
OWNER James & Nanny Rabyak BUIL ING PT.
ADDRESS _ 141 Acrebrooi Driver ��ton, BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)