29-056 (2) 04gN�fA�o
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DEPARTMENT OF BUILDING INSPECTIONS
F
INSPECTOR 212 Main Street ' Municipal Building M
Northampton, Mass. 01060
AS A HOMEOWNER I UNDERSTAND THAT I MAY APPLY FOR AND RECEIVE
A BUILDING PERMIT FOR A HOME OR ADDITION I INTEND TO LIVE IN.
I ALSO UNDERSTAND THAT I AM RESPONSIBLE FOR KNOWING THE STATE
BUILDING CODE AND ZONING ORDINANCE OF THE CITY OF NORTHAMPTON.
BEING A.HOMEOWNER AND NOT A PROFESSIONAL CONTRACTOR IN NO WAY
ABSOLVES ME OF ANY RESPONSIBILITY TO INSURE THAT ALL FACETS
OF THE RULES AND REGULATIONS ARE COMPLIED WITH.
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DISTRICT
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SIDE YARD SIDE YARD
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IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
Owner or 1
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
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans B Notes
Fee Started Approved y
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 Number B
Obtained y PP Obtained 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 ^7 j_(j FOR DEPARTMENT USE ONLY
Permit number C��(1—`1►
Building Use Group
Permit issued 19
Building 0 Fire Grading
Permit Fee $ ��'W
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�. .� MASSACHUSETTS
r
$ f OFFICE of the INSPECTOR of BUILDINGS
t Page C4 p Plot J — APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O
ZONING
1• AT (LOCATION)
, y �I= ., R�-C % DISTRICT
LOCATION IN 0.) (STREET) t
OF BETWEEN Q raJ 1� P,C /�" l� AND
BUILDING (C O�SS STREET) (CROSS STREET)0 f
LOT SUBDIVISION LOT Q5G BLOCK SIZE 10 7 GV h—T
N
11. TYPE AND COST OF BUILDING — All applicants complete Parts A — D z
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
m
1 E New building Residential Nonresidential
2 Addition(If residential, enter number 12 One family 18 D Amusement, recreational
of new housing units added, if any, �
in Part D, 13) 13 Two or more family - Enter 19 L ) Church, other religious
number of units- - - - > 20 Industrial
3 Alteration (See 2 above)
14 n Transient hotel, motel, 21 Parking garage
4 Repair, replacement or dormitory - Enter number
5 Wrecking (11 multifamily residential, of units ----- -- - -- 22 �� Service station, repair garage
enter number of units in building in 15 C] Garage 23 C Hospital, institutional
Part D, 13) 16 Carport
24 Office, bank, professional
�
6 Moving (relocation) 25 Public utility
17�� Other - Specify � y
7 El Foundation only 26 School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
e • 28 n Tanks, towers
8 Private (individual, corporation, f�t��3c3 t
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,,,,,,•.•....... 4 school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office building of industrial plant.
7'o be installed but not included If use of existing building is being changed, enter proposed use.
in the above lost //' ;r�
a. Electrical..................... p E /V • Z"
b. Plumbing ....................... i
_ Cj 4:3 1) l'Ttlj Ail-"3 T
c. Heating, air conditioning..........
d. Other (elevator, etc.).........
t...
11. TOTAL COST OF IMPROVEMENT* $ G•-o
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[D Masonry (wall bearing) 40 Public or private company 48. Number of stories................
49
31S, Wood frame 41 Private (septic tank, etc.) . Total square feet floor ores,
all floors, bused on exterior
32 Structural steel dimensions ..................... Fk?
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
� 50. Total land ores, sq. ft. ........... •` '"'
34 Other - Specify 42 n Public or private company
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,ibe central air 52. Outdoors.
36 Oil conditioniy? L. RESIDENTIAL BUILDINGS ONLY
37E-' Electricity 44 n Yes 45 No 53. Number of bedrooms..............
38 Coal
39 n Other - Speci/y Will there be an elevators Full..........
54. Number of
46 [_1 Yes 47'N No bathrooms
Partial.......
a 'OEPTN' F BUILDING INSPECTIONS BUILDING ZD- ��}•[�
! 212 Main Street o<
Northampton, MA 01060 PERMIT <a
29 - 56 VALIDATION
DATE .1'no 5 19 S2Q PERMIT NO, 36�-----
APPLICANT War I d Q }ii lde Kee_bko ADDRESS r2irLTnrr S F Q e narc _
cery —�� e e )c (CONTR'S LICENSE)
PERMIT TO X/rX4 New Building)_, STORY Garden Shed -DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
46 Gilrain Terr. ZONING URA
AT (LOCATION) DISTRICT
(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
lrrveJ
REMARKS. permit for the construction of a garden shed
AREA OR p 700.00 FEEMIT s 10.00
200
VOLUME sQ. ft• ESTIMATED COST
(CUBIC/SQUARE FEET)
Same as Applicants
OWNER BuaL
ADDRESS Same as Applicants' BY
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY • PINK ^ ASSESSORS COPY P®RfP