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DISTRICT
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IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
1.
Owner or 10'-Y /"Vu 0 � e 7 11 L,Lessee o�vC
^e� JU �cc Gam .
Builder's
2, J C License No. a259Z
Contractor -
U- e l,l e J 6 L 01301 Z73 70
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 Appli ati date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plan Review Date Plans Date Plans
Plans Review Required Check Fee Started BY Approved BY Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Obta tned Number By Permit or Approval Check Obtta t ed Number 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 �P
Building Use Group
Permit issued ° g �� 19
Bui Iding 00 Fire Grading
Permit Fee
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile
Plan Review Fee $ y
TITLE
s
CITY OF NORTHAMPTON
�• MASSACHUSETTS
r
$ e OFFICE of the INSPECTOR of BUILDINGS
Page Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all/ items in sections: 1, I1, 111, IV, and IX. O
I. L l4lUlA1�7�•'4\ ` ZONING
AT (LOCATION) � � w � rr � DISTRICT
LOCATION (NO.) TR ET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
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 rn
rn
1 ❑ New building Residential Nonresidential
2 Addition(If residential, enter number 12F-1 One family 18 Amusement, recreational
of new housing units added, if any,
in Part D, 13)
13 I Two or more fami-ly - Enter 'j� 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 (if multifamily residential, of units ------- - --s 22 Service station, repair garage
enter number of units in building in 15E] Garage 23 Hospital, institutional
Part D, 13)
16 Carport 24 Office, bank, professional
6 Moving (relocation)
7 � Foundation only 17 C� Other - Specify 25 n Public utility
26 E] School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 Other - Specify
9 L_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 ....................
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 48. Number of stories..............
31 Wood frame 41 Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 Structural steel dimensions .....................
33 Reinforced concrete H. TYPE OF WATER SUPPLY
34 Other - Specify 427 Public or private company 50. Total land area, sq. ft. ..........
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 D Gas Will there be central air 52. Outdoors........................
36 f1_11 Oil conditioning?
LrSl, L. RESIDENTIAL BUILDINGS ONLY
37 E Electricity 44 n Yes 45 No 53. Number of bedrooms..............
38 Coal
39 n Other - .Specify Will there be an elevator? Full..........
�� 54. Number of
46 l r .-_J
� Yes 47 No bathrooms
Partial.......
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Date Filed File No.
ZONING PERMIT APPLICATION
Zoning Ordinance Section 10 .2
1 . Name of Applicant: ,Cw".v C-C-Z D
Address: Telephone:
2 . Owner of Property: r
Address: Telephone
3 . Status of Applicant: Owner Contract Purchaser
Lessee �Ot3er (explain: Cz-,44,-a ou )
0 4 . Parcel Identification: Zoning Map Sheet# ParcelO
Zoning Districts)
Street Address
5 . Compliance with Zoning: Exis ing Proposed
Use of Structure/Property
Size of Structure (sq.ft. ) _72
Building height . -�
Building Coverage
Setbacks - front "0
- side o 't
- rear ,moo
Lot Size
Ll_
Frontage
Floor Area Ratio
% Open Space
0
Parking Spaces
Loading Spaces
Signs
Fill (volume & location)
6 . Narrative Description of Proposed Work Pro 'ect: (Use
a ditional sheets if necessary) #,1 wXoce- h
c
7 . Attached Plans : K Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained
herein is true and accurate to the best p my knowle
Date: j 4e) Applicant ' s Signature:
THIS SECTION FOR OFFICIAL SSE ONLY _ - - - - - - - w - -
Approved as presented
Denied as presented
Reason for Denial:
Signature of Building Inspector D
,
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z d a
a b O
Z
b z ~ (�
s r� c
Ilk
I� ro
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 7 7 3 Alterations
ras"""pro, NORTHAMPTON, MASS. ./ 7 19 Additions
Repair
APPLICATION FOR PERMIT TO ALTER
Garage
1. Location csu CC4� Lot No.
2. Owner s name_(n'a c,P- e4 Address do ggtj
3. Builder's name 6e—o o Address 2 13 42 It
Mass.Construction Supervisor's License No. 02 5'`7�2, Expiration Date 3b
4. Addition
5. Alteration
6. New Porch Vc w
7. Is existing building to be demolished?
8. Repair after the fire
9. Garage hl p No.of cars Size
10. Method of heating ° 1
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost:- Q gv,,
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible applicant
Remarks
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