36-110 (3) ZONING •
SIDE YARD SIDE YARD
IX. SITE OR PLOT PLAN For Applicant
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NOTES and Data — (For department use)
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IV. IDENTIFICATION — To be completed by all applicants '
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
1.
Owner or C � i ✓' R�i�C.CIC/�T— �--f/LC
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.
Signatu of applicant Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date P y Ions B 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 Nb B
Obtained Obtained umber y
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 lY(G'j
Building
Permit issued m j r 19 Use Group
Building �- �— Fire Grading
Permit Fee $ Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $ Get,
TITLE
CITY OF NORTHAMPTON
�. MASSACHUSETTS
• a
OFFICE of th INSPECTOR of BU LDINGS
�t •
Page Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, III, IV, and IX. O
ZONING
I• AT (LOCATION) f - �" -� ^-� / DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
H
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
1New building Res ential Nonresidential
2 Addition(If 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 n 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 (It multifamily residential, of units ------- - --� 22 Service station, repair garage
enter number of units in building in 15 Garage 23 Hospital, institutional
Part U, 13) r- 1
16 � Carport /,i 24 1 I Office, bank, professional
6 Moving (relocation) _f/L/ f_
17 � Other - SpeciJy �� 25 �_� Public utility
7 Foundation only 26 School, library, other educational
B. OWNERSHIP tyr� 27 Stores, mercantile
8-L>_<1 Private (individual, corporation, 28 n Tanks, towers
nonprofit institution, etc.) 29 Other - Specify
9 D 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,••••••••....... ��. ��CL-1 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.....r............... r A
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 F-] Public or private company 48. Number of stories..............
31 Wood frame 41 n 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 42 � 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 Gas Will there be central air 52. Outdoors........................
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 CJ Electricity 44 n Yes 45 !� ! No 53. Number of bedrooms..............
38 Coal
39 n Other - Specify Will there be on elevator° 54. Number of Full..........
-
( bathrooms
46 � Yes 47 ' No Partial........
a DEPT. OF BUILDING INSPECTIONS BUILDING '° /0 ' �)(D
212 Main Street
Northampton, MA 01060 PERMIT
36 - 110 VALIDATION
DATE 11j V 7� 19 $7 PERMIT NO. 426 !!11
LICE
APPLICANT Ri rhard Rarratt ADDRESS nre �il'I r
(N0. (STREET) (CONT R•S NSE)
NUMBER OF
PERMIT TO T jgrm p,� ICwmn STORY QA@ DWELLING UNITS
P S USE)
ZONING IIDA
AT (LOCATION) DISTRRI CT
(NO.) (STREET
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: e
and self locking gate surrounding it.
512 sq. ft. r$ 4,500.00 PERMIT $ 10.00
AREA OR VOLUME ESTIMATED COST FEE
(CUBIC/SQUARE FEET) /\
Same as Applicant �'
OWNER I BUILDIN �� X� ��'�
ADDRESS Same as Applicant s BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - AS ESSORS COPY odp