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36-169 (7) ZONING • FRONT DISTRICT .D SIDE YARD � NMI I Fj REAR YARD IX. 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IDENTIFICATION — To be completed by all applicants Name Mailing address — Number, street, city, and State ZIP code Tel. No 4' �It —7/j C"l r7 I. C� Owner o r / -'7— `7 Lessee Bui Ider's L. tY- License No. Contractor �w 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. Si t re of a p i nt Address Application date 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 $ OTHER Is I VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approval Check Date Number B Permit or Approval Check Date Number B Obtained y PP 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 II. VALIDATION Building FOR DEPARTMENT USE ONLY Permit number Building Use Group Permit issued 19 Fe Building Fire Grading Permit Fee $ Live Loading Certificate of Occupancy $ Occupancy Load Appro Drain Tile $ \ �� Plan Review Fee Li TITLE CITY OF NORTHAMPTON MASSACHUSETTS OFFICE of the INSPECTOR of BUILDINGS Page ' Plot APPLICATION FOR ZONING PERMIT AND INSPECTOR BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. 0 ` ZONING I. / � ! 4 � J� DISTRICT AT (LOCATION) LOCATION (NO.) (STREET) 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 m 1 ❑ New building Residential Nonresidential 2 ❑ Addition(IJ residential, enter number 12 One family 18 ❑ Amusement, recreational of neu, bousing units added, if any, in Part D, 13) 13 ❑� Two or more family — Inter 19 �❑ Church, other religious number of units— — -- — --� 20 L� Industrial 3 Alteration (See 2 above) 14 ❑ Transient hotel, motel, 21 Parking garage 4 ❑ Repair, replacement or dormitory — E_'nter number 5 ❑ Wrecking (if 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 E] Moving (relocation) 17❑ Other — Specify 25 ❑ Public utility 7 ❑ Foundation only Lir 26 ❑ School, library, other educational B. OWNERSHIP ��� ��--� 27 ❑ Stores, mercantile 28 Tanks, towers 8 X Private (individual, corporation, ►ti ...mac ❑ r t t J�.�1'i ❑ 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. 7'o 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 $ 7_1 < 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 L❑ Reinforced concrete H. TYPE OF WATER SUPPLY cci 42 Public or company 50. Total land ores, sq. ft. .......... S 34 l � Other — p� Jy private com an 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 52. Outdoors........................ LJ WillYlyere be central air 36 '—] Oil conditionlr�q\ L. RESIDENTIAL BUILDINGS ONLY 37 Electricity >, es ! 45 No 53. Number of bedrooms.............38 _ Coal 39 L Other — Specify be an elevators Full../...... 54. Number of 46 f Yes 47 r No bathrooms Partial...... I INSPECTION RECORD DATE NOTE PROGRESS - CRITICISMS AND REMARKS INSPECTOR FIELD COPY ECTIONS BUILDING manj NrMq MA. 01060 PERMIT 36 - 169 !� 8 r, DATE October 28, 1980 Rd. NO. 651 APPLICANT ADDRESS 747 Florence Rd. IN 0.) (STREET) (CONTR'S LICENSE) �����.�iiii,,,,,,, NUMBER OF 1 PERMIT TO b L at"ft ) STORY For w"d-burning stove DWELLING UNITS (TYPE F IMPROVEMENT) (PROPOSED USE) ZONING AT (LOCATION) 747 _y FlovAuce Read DISTRICT SR (NO.) R E ) rn BETWEEN -'- AND `o (CRO TREET) (CROSS STREET) rn LOT IL m SUBDIVISION ol LOT BLOCK SIZE pa Y , BUILDING IS TO BE FT, WIDE BE• FT. L G BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION m ) O Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION � - (TYPE) '! w LL REMARKS: NOW Ulerk chimney and wood-burning stave AREA OR FEE in in an VOLUME ESTIMATED COST $ ►�j (CUBIC/SQUARE FEET) OWNER Daniel Pepin B D ADDRESS 747 Florence Rd., Northampton, Na. 01060 e