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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. Signa 'rg of applicant Address Application date D0 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 Permit or Approval Check Date Number By Permit or Approval Check Date Number B Obtained Obtained y BOILER _- 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 Building Permit issued 19__,,2 _ Building Permit Fee $ Certificate of Occupancy Approved by: Drain Tile Plan Review Fee S— G TIT Crxty of Xort4auipton �IDSSMCIf1ISettS Offire of the 31naptrtor of j$uilbinp APPLICATION FOR ZONING PERMIT AND PagePlot�_ BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, 11, Ill, 1V, and IX. Z O C ZONING I• AT (LOCATION) -" DISTRICT LOCATION (NO.) (STREET)~ OF BETWEEN AND BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE 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 Re dential Nonresidential 2 Addition(l/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) 4 ❑ Repair, replacement 14 E] Transient hotel, motel, 21 ❑ Parking garage 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) 16 El Carport 24❑ Office, bank, professional 6 ❑ Moving (relocation) p 7 ❑ Foundation only 17 ❑ Other - Specify 25 ❑ Public utility 26 ❑ School, library, other educational B. OWNERSHIP 27 ❑ Stores, mercantile Private (individual, corporation, 28❑ Tonks,'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.,,,.•,,,.,,••,• 1' school, secondary school, college, parochial school, parking garage for, department store, rental office building, office building at industrial plant. To be insealled 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 Is Ill. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L; 113 for wrecking, complete only Part J, for all others skip to IV. y E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS M m 30 F�Masonry (wall bearing) 40 Public or private company 48. Number of stories............... 31 Wood frame ❑ Private (septic Conk, etc.) 49. Total square feet of floor area, all floors, bas Ad o xter,or 4 A♦ 32❑ Structural steel dimensiony� ..y .�. 33❑ Reinforced concrete H. TYCE OF WATER SUPPLY 34❑ Other - Specify 42 Public or private company 50. Total land area, sq. ft. ........... V 43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ....................... r O 35 ❑ Gas Will there be central air 52. Outdoors........................ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY Electricity 44❑ Yes 45 No 53. Number of bedrooms.............. 38 ❑ Coal 39❑ Other - 5pecify Will there be an elevator? Full.......... �J 54. Number of °-r 46 ❑ Yes 47 V No bathrooms Partial....... 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 DEPT. FILE COPY ZO -- -~ ✓-,;, CITY OF N©RTHAAtPTON BUILDING 0a NORTHAMPTON, Kh. 01060 35-110 PERMIT VALIDATION DATE June 6, 1978 PERMIT NO, 210 APPLICANT Audrey Helems ADDRESS 29 Cahillane Terrace (NO.) (STREET) (CONTR'S LICENSE) PERMIT TO Residence Addlt.( 1 ) STORY Residence DWELLRING OF UNITS 1 (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) 29 Cahillane Terrace ZONING SR AT (LOCATION) DISTRICT (NO.) (STREET) I m BETWEEN AND m (CROSS STREET) (CROSS STREET) LOT e SUBDIVISION LOT BLOCK SIZE m a p BUILDING IS TO BE 12 FT. WIDE BY 20 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION M O Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION g (TYPE) o REMARKS: Addition - wood deck. screened porch, wood frame roof AREA OR PER MIT VOLUME ESTIMATED COST $ 1 -901) -On FE nn (CUBIC/SQUARE FEET) OWNER Edgard J. Helems BUI IN EPT. ADDRESS 29 Cahillane `Terrace BY (Affidavit on reverse side of application to be completed by outho ' agent of owner)