35-219 (6) ZONING •
FRONT
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT
Applicant----------------------------------------------- --------_.__... ..........
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, strut, city, aril State. ZIP code Tel. No.
O] ner or x �
Lessee /07
L r �� Builder's � l �
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.
Signatf e of applic nt Address
Application date
00 NOT WRITE EL0W THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans Date Plans
Fee Started By Approved BY Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS D ate
Date
Permit or Approval Check Dare Number B Permit or Approval Check obtained Number By
Obtained Y PP
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
Permit number gkfl FOR DEPARTMENT USE ONLY
Bui Iding.
Permit issued Use Group
---���� r 19
Building ^� Fire Grading
Permit Fee $__ l q ��
Live Loading
Certificate of Occupancy $ Occupancy Load
Drain Tile $ APP by:
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
« MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
Page Plot 2 APPLICATION FOR
4— ZONING PERMIT AND
INSPECTOR
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. 0
ZONING s
4! 0 ! DISTRICT t 44,99 060 101 I• AT (LOCATION)
LOCATION (NO.) (STREET)
OF BETWEEN n�` �- _ AND
BUILDING � (CROSS STREET) (CROSS STREET)
SUBDIVISION LOT A�Q BLOCK LOZE
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 New building Residential Nonresidential
2 Addition(If residential, enter number 12 One family 18 �❑ Amusement, recreational
of neu, 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) 14 Transient hotel, motel,
❑ 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (I(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 — Speci/y 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
P processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,,,,,,•....... 6� 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 .....................
c. Heating, air conditioning..........
d. Other (elevator, etc.)............. q
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
48. Number of stories...............
30 L] Masonry (wall bearing) 40 ❑ Public or private company
p
41 �❑ Private (septic tank, etc.) 49. Total square feet of floor area,
31 Wood frame 1T all floors, based on exterior
32 Structural steel dimensions ..................... 3
33 �❑_ Reinforced concrete H. TYPE OF WATER SUPPLY ?9
34 ❑ Other — Specify
42 Public or private company 50. Total land area, sq. fT. ........... 1K
43 Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 ❑ Gas Will there be central air 52. Outdoors........................
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY J�
37 Electricity 441$ Yes 45 No 53. Number of bedrooms.............. °7
38 ❑ Coal
39 ❑ 54. Number of
Other — Specify Will there be an elevator? Full..........
46 ❑j Yes 47 a No bathrooms Partial........ 1
. _,_._ ,,.<.,�.._._,m�u..�
�_ a
DEPT. OF BUILDING INSPECTIONS BUILDING �O �(
212 Main Street oa
7 Northampton, MA 01060 PERMIT
35 - 219-20 8p VALIDATION
DATE August , 19 85 PERMIT NO. 469
APPLICANT L.P• Audette ADDRESS 60 Whiteloaf Rd.,, �nl�ton,_12,1,2'7
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
New Building
PERMIT TO g �`) STORY One Family/Garage e DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION)
Lot #20 Ladyslipper Lane D STR CT AT
(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: permit for the construction of a single
and an attached garage
AREA OR 2324 sq. ft. ESTIMATED COST .� 1222000.00 FEEMIT $ 741.80
VOLUME
(CUBIC/SQUARE FEET)
Same as Applicant
OWNER ame as scant-s BUIL
ADDRESS pp BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pQ-11'