36-248 (10) ZONING •
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
IX. SITE OR •
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Ca ( �{v� Nc:j2?1 f iCokg �S 42r1>1 Sff¢-645
Owner or
Lessee 1 F—0O2tuCe &.4
1, ., ?kD gZ ft C42 r (t LiicenserNo.
Contractor
3(Z4 q
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.
$ignotu a of opplo
icn 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 $
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 FOR DEPARTMENT USE ONLY
Permit number
Building ' t Use Group
Permit issued �.��� — 19 —
Building C) t-y---) Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by: n
C7Drain Tile $
Plan Review Fee $ W VVV
TITLE
CITY OF NORTHAMPTON
�• .e MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page Plot Oo APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, lll, IV, and IX. O
ZONING
I• AT (LOCATION) DISTRICT
LOCATION '�, (NO.) �6' (STREET) ` (/ q�
OF BETWEEN F-W i2t7t�c �- AND iJ> A.) 'mil ` L >
BUILDING }/� ��// (CROSS STREET) �j (CROSS STREET)
SUBDIVISION Al-API-e- �(Jq4' LOT ✓ LOT
BLOCK SIZE T
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
m
1'57Z New building Residential Nonresidential
2 M Addition(If residential, enter number
f 12F-1 One family 18 E] 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
3 ❑ Alteration (See 2 above)
14 ❑ Transient hotel, motel, 21 C� Parking garage
4❑ Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (11 multifamily residential, of units ——————— — -0. 22 Service station, repair garage
enter number of units in building in 15'X Garage 23 ❑� Hospital, institutional
Part D, 13) ❑
16 Carport 24 L� Office, bank, professional
6❑ Moving (relocation)
17❑ Other — Specify 25❑ Public utility
-r�Foundation only
26 ❑� School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 Private (individual, corporation, 28 Tanks, towers
nonprofit institution, etc.) 29❑ Other — Specify
9 ❑ Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food t
�y processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,,,,•,,,•,,,•, 2 V`- 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 TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
30�Masonry (wall bearing) 40 ❑ Public or private company 48• Number of stories..............
49. Total square feet of floor area,
31 ❑ Wood frame 41 ❑ Private (septic tank, etc.) 6_7
all floors, based on exterior
32 ❑ Structural steel dimensions ...................
33 ❑ Reinforced concrete 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
'PRINCIPAL TYPE OF HEATING FUEL I TYPE OF MECHANICAL 51. Enclosed .......................
(
35 ❑ Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 ❑ Yes 45 r� No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevator? Full..........
54. Number of
46 [_ � Yes 47 'D No bathrooms
Partial.......
DEPT.0 BUILDING INSPECTIONS BUILDING Z° I
212 Main Street 0a '_ l
Northampton, MA 01060 PERMIT
36 - 89&90-3 VALIDATION
,,} p //DATE 7 MAV 12, 19 AS PERMIT NO. 102
APPLICANT Nei- Wem3bea�9! b9r�� r� ADDRESS_408 N(;).rth Farms Rd 03124Q
(NO.) STREET) (CONTR'S LICENSE)
Foundation Only etached Garage NUMBER OF
PERMIT TO y 1_I STORY g DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) Lot #3 Maple Ridge ZONING SR
DISTRICT
(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; permit for the foundation only of a new 2 car detached garage
AREA OR s
VOLUME 576 so. ft. ESTIMATED COST $ 2,000.00 FEEMIT 10.00
(CUBIC/SQUARE FEET)
OWNER Same as Applicant WPO.
BUILDIN
ADDRESS Same as Applicant's BY
WHITE - FILE COPY . GREEN - FIELD COPY w CANARY - APPLICANT COPY • PINK - ASSESSORS COPY P}NT P