35-064 4 r� y
In zccord:;nco with Articlo XI of the Z onin; C-rdinanco, an for a .
Zonirr, Pormit muat includo a Plot Plan. The follo�ring charact;ristics of the
parcel must be shorn.
1. Dimensions of the lot,
2. Locations And size of all buildings.
3. !average finished grade of all structures existing and proposed.
4. Use of all buildings existing and proposed.
5, Set Backs as indicated on the enclosed plan.
Abuttors i:ane
Lot _ ;da.
Lot _ Ft.
Rear Yard / V
Abuttors Abuttors
Name Name
Lot No. / Lot No.
If this is a . Sideyard House Side?*ard K> If ti is is a
corner lot, write corner lot, write
in the name of the in the name of the
other street. other street.
Set Bzck
_P +,
�°a a
Lot _Ft.
�S/ ITan� of Street
Indicate location of garage or accessory buildings with a dashed line.
i�rdicate location of Serer nook—up 12
List all past plans, applications, per:Tiits, ,arianc-3s etc. a_rd Comes _=n ing- dates that
;nave baen processed by this office.
I certify that the enclosed apnli n plot plan co,7PL e and correci,
-n�tur of Caner Date
/f
Pago"o, Lot No. -
:
APPLICATION L-)t (,*',f-(0 ,4
',onin- Ordimince Sf�cti,�,r 10.:, cc J-;�- P me
tj 0.
b. 7xp
I Ci r e s s A,-U r e c,,.
elephone Tcloplinw,
"'his section is to be filled out in Dccordl-irlce of Dir.,icnsionril ind
,ensity Pegqlatione:. M.
A--'TIC1111' VI)
t
U�7 C T,9 L � rert D� , ..lei. Min. On.
trict
Ar, n-
d t)I over. S ace
t— Exis tin.c,_
reserf— Proposed
rlc the appropri,-,te box to, indicnte, tlic iisc of tit(- p,-rc(--I:
ron-Conforminr Lct =,r.d ,',)r ."fracture. St;ccify
[ _Residential
,lc Frni.ly
Duple-•- t h(,i
Business
Industrial
Ins tituti ()—1
Subdivision D R,:-j, F I P.11.D.
Sub(livicior ,%rith "Apl:ru- -�1-No
= Plnnnirt- T�oard Ai)prav,I:
Zonilli- 'po,,rd P, n:
= Cit-,, COUI-Xil Excrpt-Joij 8. 16.101
.-)ter61LCd Protection District Over 1,yy: (-.1'. Sect. .-,17;) 0 yes FG
Spacc Pequirementf,-: (z'x. :-,cct. %1) Re;;.qArcc! —Pr,)pose,' —
-adinr- Space Peguirementc: (Z.(.'. -ect. 8. 2) Reqt7ired—ProFoce('-
,Igns: (Z.O. Art, VII) Y,6 C ro
I-:1virorimental Performance �Land.ardr,: ( '.0, Art, X11) Yes Or>o
)lot Plan Yes No Site Plan 0 yes IT,,
10.2) 10—? and 10.11
D--t
This r-,(-ction, for 0F.1"D"ILL u.,-le, or'Q,:
=Aprrov,-i.l ns presci,t-11:
=Modifications rcccf—,-r�- -For
Return: (1:oi,c,
Dcnin! : Pr- r--)i
Officer Da'Le
Sigr,,-�ture o t D,-�t e
~
To the Inspector of Buildings:—
The undersigned hereby applies for w permit to build, move, alter, or repair, uoonrdbzg to the
following specifications.—
I' Owner's name ....- � ± � --..^/�........... U
--------------------------------..
�� � . ��
2' Ovvuor'o address --.�-�'�---..,x ��u.�~"°"----L34...................................................................................................................
3. Architect's name -..'. '--- - --_---'~-___---.~'-.--~-_---
_ Builder's- -_--- ----__-_--
- Builder's- ------- -------------r - e.
8' Location of Building. Street Nu'
7' Io this u removal or new building..................... .............................................................................................................
0. If removal, from vrbore ......................... ----.'----_~------,--_-~-',,._~~~,
9, What is the DnrDnea of building
10. Material o2 building ......................................... ...............................................................................................................................................
11. If a dwelling, for bon' zumoy families
18' Is there to be a store in the building ..............ALo.........................................................................................................................
13' Sbra of building, No' of foot front ;No' of feet deep ... No. of stories .....................
14. Size oƒ ell, No. oƒ feet front ........................; No. uf feet deep ........................; No. of feet high ...........................
15' 2bzo of Lot ---------_'-----'_'_--'--FmotWido '. ............. Feet Deep -- -��/ /
�� F�
16. How near the line of atreot .... ,=-�-,--__---_.-.,--------------_---_______________.
�� /7 � � °�
17' IIovr near the line adjoining lot. Right '��'��''--.....' Left^x-'�e-u~�---; Rear tw-,
10' Neare st b i|di z ���.
19 uteria� oltbe � �c����°��.w« 'a- rTQ' " '' ' u"e *''n'��' �--�s7���'�_----'----'e--' -. .. .. . . .. . --''
20. Sizoof tinubera, 1�� - --; 2od -.��.��.J�-.. � 8rd -..�6}i'y�-� �t� -. .. .-..; 5tb ---------..
/ Jr�- '
21. 2�o' of feet span ---_-...»�� .---_---_----. I)iataooeoo centers -��..4mx.......................................................
22, Will the building be erected on solid or filled land -.-'.5'.a.I...�D_-------_-._-'-'. --...
23' What ia the material of foundation -l~~..��J����^�L-x�-'-'--_-----_---; Footb��
'
24. Will the roof be flat orpitched ; Covering �
25' Heat; mtouru, hot water, turuuoo, stoves ..........................................; 1'ovvor nil burner ................................................
26, Fireplace ; Insulation
27' Hon' many sinks ............; Toilets ..... .....; Lmvatorieo ---; Bathtubs-_; Showers............; Sottoba ---
20' City Service; Water ........................ Sewer ........................; Road Surface ...........................; Sidewalk ........................
29' Is lot on accepted street
30' Estimated cost (zunatb� �l�ed out) .......... W.-...-----'-------_______________
Applicant agrees to give the Inspector mfBuildings 24 hours' notice before lathing or
plastering this building. This building will omafmxm to t� ra ireo�ent of the law.
SigumtoceofuDplic ~....-',�&�c.xu�z.�°=�.......................................................
^ No.JAU----'-_--
R MARKS
-~^'-----^^~-^^''-~'''^'^''-'~'-----~---~-~^---^''-----~'~^--~~~--~'----'--^~'^^'--'~---~~'----'~----'''
'~^'^~'^''~^^''~~''~'-~'~'-'^''''^'^^'^~^''~^^''-~^'`-^^^-'--------^~~~-'~~~---------------''~----'-'------
-^^^^~'-~---~`-~'-----`---^~-~--^-~--~---------~----~~----'~--`--~-~~-~-------~-'-`
--''~^-'~^'-^'--^--^'-'--'--------`--~--~-------`-`-------`------------------`-------`-`
I hereby certify that the proposed work is outhorized'by the owner of record
and 1 have been authorized by the owner to make- 'this 'application 'as his
authorized agent.
SIGNATURE OF AGENTT
ADDRESS
(NUMBER) (STREET) (CITY
APPROVED- BY TITLE
DATE 19
Zo
DEPT. PILE COPY
City of Northampton BUILDING $a
Massachusetts a
Office of the Inspector of BuildingsPERMIT
VALIDATION
TTE MIT NO.
19 `� E
APPLICANT ADDRESS
(140.) if (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT T STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCAT(ON) ° DISTRICT"
(NO.) (STREET)
a BETWEEN AND
a
(CROSS STREET) (CROSS STREET)
LOT
m SUBDIVISION LOT BLOCK SIZE
a
U
O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
I (TYPE)
Cr
0 ,.}///t
REMARKS: 6-4tt� �e� �7
AREA OR PERMIT Vc O
VOLUME ESTIMATED COST $ FEE $
(CUBIC/SQUARE F ,
OWNER !ii'T
BUILDIN
10win&Y ADDRESS ' BY a4 I Y,
(Affidavit on reverse side of application to be completed by authorized agent owner)