36-201 (3) ZONING •
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
IX. SITE OR PLOT
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NOTES and Data — (For department use)
{�
1�(,o
-7 .
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
` i
Owner or L- t
Lessee p�
v
2 p�� ,l Builder's
f���' 'CJ 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.
Signatur I f a ica ddresss MA-
Application ate
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans
Fee Started y Approved By Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL
OTHER
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 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 l
Building Use Group
Permit issued � � ' ( 19 _
Building Fire Grading
Permit Fee $ � � Live Loading
Certificate of Occupancy $ Occupancy Load
$ Approved by:
Drain Tile
,r
Plan Review Fee $
TITLE
y.
CITY OF NORTHAMPTON
�. MASSACHUSETTS
$ OFFICE of t e INSPECTOR of ILDINGS
Page Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, II, 111, IV, and IX. ////^����' O
lr ZONING Q
(• AT (LOCATION) �+ DISTRICT
LOCATION IN 0.) (STREET)
OF BETWEEN AND
�J"y ll (CROSS STREET) (CROSS STREET)
BUILDING LOT
SUBDIVISION ��■ -� LOT BLOCK SIZE
I //
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D X
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
m
1 New building Residential Nonresidential
2 Addition(/f residential, enter number 12 POne 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
number of units- - - - 20 Industrial
30 Alteration (See 2 above)
14 Transient hotel, motel, 21 parking garage
4 E Repair, replacement or dormitory - Enter number
of units ------- - -i 22 Service station, repair garage
5 � Wrecking (fl multifamily residential, -
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 F-� Other - Speci/y 25 ❑ Public utility
7 Foundation only 26 School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 Private(individual, corporation, 28 ❑ Tonks, towers
nonprofit institution, etc.) 29 0 Other - Specify
9 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..................... e�
b. Plumbing ..................... ���
c. Heating, air conditioning.......... no
d. Other (elevator, etc.)............. 1
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..............
49. Total square Feet floor area,
31 Wood frame 41 Private (septic tank, etc.)
all floors, based on exterior Z� I�
32 Structural steel dimensions ..................... —(
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY +
2 Public or private company 50. Total land area, sq. ft. `.` ..
4
34 � Other - Specify � p
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 Electricity 44 F] Yes 45 No 53. Number of bedrooms.............
38 Coal
39 Other - Specify Will there be on elevators Full......
54. Number of
46 Yes 47 No bathrooms partial...l��
GtL of Wort4alll}tan
9 � �asscl�nsctb —
g Offirt of the )nsptrtor of Ilttilbings `
212 Main Street•Municipal Building
Northampton, Mass. 01060 •'
4550
CERTIFICATE OF OCCUPANCY
June 19, 1987
Page No. 11 Plot 77`2
Building (Name) New Sjngl : Family Dwelling Garage Address Lnt 42 Wia irhnrry Linn
Owner Sundance Design Address P.O. lox 780,E Um-champl;on
Applicant Same, Address Su 11L
Use: 1st Residential Occupancy
2nd Residential Occupancy
3rd Occupancy
4th Occupancy
Zone District SR
Required Inspections:
New Building X Existing Building
h
Elevator Electrical(. '`,---r
Plumbing ". Fire J
- � t
Building ) " GAS: Other
21
Inspector of Bull ngs
DEPT. OlP BUILIOING INSPECTIONS BUILDING ZO
212 Main Street oa
Northampton, MA 01060 PERMIT <a
36 - 77-2 VALIDATION
DATE November 4, 19 86 PERMIT NO. 650
APPLICANT Sundance Design ADDRESS P.O. Box 780, Northampton
(NO,i (STREET) (CONTR'S LICENSE)
PERMIT TO New Bu i 1 d i na l_1 STORY
One Fami 1 v/Garage DWELLING UNITS +1
(TYPE OF IMPROVEME
y�NT) NO. (PROPOSED USE)
Lot ttZ ZONING SR
AT (LOCATION) DISTRICT
(ND.) (STREET)1 u 1�
BETWEEN ` V AND
(CROSS STREET) (LR093 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 new single family dwell ing/oar ge/2 floors _____
AREA OR PERMIT
VOLUME �77g CCU ft ESTIMATED COST $ 7 5t7 Q(7(�_QQ FEE $ 727•��
(CUBIC/SQUARE FEET)
OWNER damp ac Appl i rant — BUI
ADDRESS ;amp A5, ATn l i r a nt I g BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY p0-1p
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DEC 1 5 1986
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