36-140 (3) ZONING •
DISTRICT
I
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NOTES and Data — (For department use)
Ice
IV. IDENTIFICATION — To be completed by all applicants '
Name Mailing address — Number, street, city, anti State ZIP code Tel. Nor
1. ` d
Owner or �- �'V V �rn `Cif r. OI u
Lessee /
!] Builder's
L. L!isC—ICk— / .<c w Y214 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 appli S9_14on as uthorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature of cant Address r Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
9 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER
Vi. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obtained Number By Permit or Approval Check Obtained 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 S FOR DEPARTMENT USE ONLY
Permit number /
Building- v Use Group
Permit issued 19
Building Fire Grading
Permit Fee $ _ 42! Live Loading
Certificate of Occupancy $ Occupancy Load
approve
Drain Tile $
Plan Review Fee $
TITLE
;o CITY OF NORTHAMPTON
MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page _1 160 Plot qo APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING
• AT (LOCATION) �' n DISTRICT
LOCATION (No.) ST*E: T
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vr
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D A
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use M
M
1 ❑ New building R idential Nonresidential
Addition(IJ 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
3 Alteration (.See 2 above)
number of units— — — — --> 20 ❑ Industrial
❑
14 ❑ Transient hotel, motel, 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (11 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 — Specify 25 ❑ Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. ERSHIP 27 ❑ Stores, mercantile
8 Private (individual, corporation, 28 ❑ 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................ < 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 $I00 '
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................
49
3� Wood Frame 41 ❑ Private (septic tank, etc.) . Total square Feet 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 ores, 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 L❑j Gas Will there be central air 52. Outdoors........................
conditioning?
36 ❑ Oil L. RESIDENTIAL BUILDINGS ONLY n
37 _ j Electricity 44 E� Yes 45 _: No 53. Number of bedrooms.............. J
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevator? Full..........
54. Number of
46 P, Yes 47 No bathrooms
Portial........
Department of Building Inspections
212 Main Street
Northampton, Ma. 01060 BUILDING o° y.�� ��
I EL
• PERMIT
36 - 140
VALIDATION
DATE il 2. 19 82 PERMIT NO. 109
APPLICANT Kim IkeScia ADDRESS 272 Crescent
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO A 7A4 t4 nn ( ) STORY o NUMBER OF -
d_ —1-- Living-BOiQ>;ll DWELLING UNITS �
(TYPE OF IMPROVEMENT) N0. (PROPOSED UA)
ZONING
AT (LOCATION) 756 Brookside niE=l Circle DISTRICT ITRA
(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: 16' X 16' addition
AREA
VOLUME 196 ESTIMATED COST $ FERMIT
(CUBIC/SQUARE FEET)
OWNER Albert Hebert �t � I
B U I I �"
ADDRESS 256 Bronkside Circle_ N'ten_., Ma_ BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY PINK - SSESSORS COPY