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35-169 (13) Vill. ZONING PLAN EXAMINERS NOTES DISTRICT USE FRONT YARD SIDE YARD SIDE YARD REAR YARD NOTES IX. 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IDENTIFICATION - To be completed by all applicants Namee Mailing address — Number, street, city, and Stag ZIP code Tel. No. Owner or Lessee Builder's 2. License No. Contractor / 3. L 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. Signatur of a liicccaanttJ Address �r !� W Application date !t 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 Is OTHER Is VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approval Check Date Number By Permit or Approval Check Date Number B Obtained 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 FOR DEPARTMENT USE ONLY Permit number Building (3, Use Group Permit issued /-�: 13K7 19A-9-_ Building / Fire Grading Permit Fee $ �(lL—�(� Live Loading Certificate of Occupancy $ Occupancy Load Approved by: Drain Tile $ Plan Review Fee $ _ CITY OF NORTHAMPTON �• ���~ MASSACHUSETTS t $ e OFFICE of the INSPECTOR of BUILDINGS Page_ & ,,! Plot — APPLICATION FOR INSPECTOR ZONING PERMIT AND BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, 11, Ill, IV, and IX. O /.. ZONING I• AT (LOCATION) y �2 DISTRICT LOCATION "° ' STREET' OF BETWEEN AND BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE to 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 Res•dential Nonresidential 2>e Addition(If residential, enter number 12 One family 16 ❑ Amusement, recreational of new housing units added, if any, in Part D, 13) 13 F-1 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 number o units - 22 ❑ Service station, repair garage 5 ❑ Wrecking (1l multifamily residential, J ------- - 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 - Specify 25 C� Public utility 7 Foundation only 26 ❑ School, library, other educational B. OWNERSHIP 27 ❑ Stores, mercantile 28 ❑ Tanks, towers 8 Private (individual, corporation, Specify Other - nonprofit institution, etc.) 29 ❑ P fy 9 ❑J 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 changed, enter proposed use. in the above cost a. Electrical..................... �) b. Plumbing ....................... A&I .� c. Heating, air conditioning.......... d. Other (elevator, etc.)............. 11. TOTAL COST OF IMPROVEMENT $ �© 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❑ Masonry (wall bearing) 40 Public or private company 49• Number of stories of floor frame 41 ❑ Private (septic tank, etc.) 49. Total square Feet n floor area, all floors, based on exterior 32 ❑ Structural steel dimensions ..................... 33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY 34 L7] 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........................ 3N il conditioning? L. RESIDENTIAL BUILDINGS ONLY 3lectricit 44 Yes 45 1- -I Ne __ y ❑ ! 53. Number of bedrooms.. ..... 38 C] Coal 39 n Other - Specify Will there be an elevator? / ull..... 54. Number of • 46 [-] Yes 47 ❑ No bathrooms Partial....... Department of Building Inspections 212 Mainagtm4et BUILDING '9 Northampton, Ma. 01060 -r- °a /�' ' �� PERMI 35 - 169 VALIDATION DATE NoyptnI]Pr if), 19}32 PERMIT NO. 667 APPLICANT mr-Kenna —Jr. ADDRESS 1345 R„rtc Pmt Rd (NO.) (STREET) (CONTR'S LICENSE) NUMBER OF -- PERMIT TO ( 4) STORY Porch DWELLING UNITS 1 - (TYPE O IMPROVEMENT) NO. (PROPOSED USE) ZONING SR AT (LOCATION) 13/49 R71rt. Pit Road 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 (TYPE) REMARKS: 10'' X 141 adel4 t4on to front porch, suclose—p arch AREA OR PERMIT . � VOLUME ESTIMATED COST $ 00() FEE �� no (CUBIC/SQUARE FEET) La OWNER John McKenna, Jr. A J ADDRESS 1345 Burts Pit Rd. , Northampton, Ma. 01060 BYIL NG D PT. WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT C INK - ASSESSORS COPY