35-007 (13) ZONING •
DISTRICT
FRONT YARD
•
SIDE YARD SIDE YARD b
REAR YARD Pilo
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IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or
Lessee
�7 Builder's
1, 1. License No.
Contractor
3. "Luw�
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
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
q Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Obtained 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
Bul Iding. Use Group
Permit issued -0"e" '( f- 1923
Building Fire Grading
Permit Fee $ WPIM
Live Loading
Certificate of Occupancy $ Occupancy Load
A ved by:
Drain Tile $
Plan Review Fee $
TITLE
« QS ti CITY OF NORTHAMPTON
MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
,uT Page 3S' Plot 1 APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING
• AT (LOCATION) DISTRICT
LOCATION (N0.) (STREET)
OF BETWEEN 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 D New building Residential Nonresidential
2 X Addition(IJ residential, enter number 12 One family 18 E] Amusement, recreational
of new bousing 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 nuriber
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) 16 Carport 24 Office, bank, professional
6 Moving (relocation)
17 Other — SpeciJy_ 25 Public utility
7 Foundation only 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•.•••••,••••..•• 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€hanged, enter proposed use.
in the above cost
a. Electrical.......................b. Plumbing Plumbing .....................
c. Heating, air conditioning..........
d. Other(elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $ 800d
111. 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..............
31 Wood frame 41 Private (septic tank, etc.) 49• Total square feet of floor area, ��yA
all floors, based on exterior
32 Structural steel dimensions ..................... Nil!
33 n 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
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 j Electricity 44 Y 45 �l No
- �__� es �- 53. Number of bedrooms..............
38 Coal
39 ` Other — Speci%y Will there be an elevator? Full..........
�l 54. Number of
U
46 P Yes 47 No bathrooms
Partial.......
lcmarL.icnt OF Buildln�� Tnspcct-lonf�
—2 il laill S11--rect- BUILDING 'q
z
lorthai'pton, "asz�.
T .9
PE
RMI 2 IL ( .3,5
V A L!D AT ION
7
DATE July 14, 19 PERMIT NO.
APPLICANT ADDRESS 5 i"ont 'ponC7
(STREET) (CONVI.l LICENSE)
NUMBER OF
PERMIT TO STORY a I t p r c-,s & r-r r-P,n -7 DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. IPROPOSED USE)
ZONING
AT (LOCATION) 15 -v ie s t gar;',,s o a -DISTRICT- Xin
(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, pqn,,i L for a bloell- 12' lbul ridu'--Lion —(-4" 31"G
AREA OR PERMIT s
VOLUME ESTIMATED COST $ FEE
(CUBIC/SQUARE FEET)
& Carla Tailou-
OWNER
BUI IT
ADDRESS 1 :) -rqt BY
7
WHITE - FILE COPY GREEN - FIELD COPY CANARY - APPLICANT COPY PINK - ASSESSORS COPY