36-249 (2) ZONING •
DISTRICT
REAR YARD
IX. SITE OR PLOT
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
J /A-t rl 21`tf s silf-G
Owner or
Lessee f(� .}��, V�
2. rR/ �iG�/� CCS� �� t� Licenser No.
Contractor
31 Z4G%
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.
Sign ture of applicant Address Application date
DO 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
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
VII. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued )q�
Building Fire Grading
Permit Fee $ Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�. .� MASSACHUSETTS
e OFFICE of the INSPECTOR coxf� dBUILDINGS
T Page Plot n� C► �� " APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
Q ZONING
I• AT (LOCATION) l 7 I� DISTRICT
LOCATION NO') ff; (STREET)
OF BETWEEN Fla AND ��J/✓�(T ( J����L'
BUILDING ��,ff�� (CROSSSS STREET) (CROSS STREET)
LOT
SUBDIVISION /��//Jf t71.j-Z-f✓+ �I LOT--A!I—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
m
1 KNew building Residential Nonresidential
2 ❑ Addition((] 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
number of units— — — — --)� 20❑ Industrial
3 ❑ Alteration (See 2 above)
14 Transient hotel, motel,
21 Parking garage
4 ❑ Repair, replacement or dormitory — Enter number r
o/ units ————— i 22 L] Service station, repair garage
5 F-1 —— — -
Wrecking (If multifamily residential, Hospital, institutional os r
enter number of units in building in 15 Garage 23 L� H p
Part D, 13) 16 Carport
24 ❑ Office, bank, professional
❑
6 ❑ Moving (relocation)
17❑ Other — Speci/y 25❑ Public utility
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP 27 I❑ 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
/?_000 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 $
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 Y P E OF SEWAGE DISPOSAL J. DIMENSIONS
30 ❑ Masonry 8. Number of stories.............
y (wall bearing) 40 ❑ Public or private company
49. Total square feet of floor area,
31 Wood frame 41 D Private (septic tank, etc.) all floors, based on exterior
32 E] Structural steel dimensions ..................... ?(p
33 E] Reinforced concrete 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 IPE OF MECHANICAL
35 ❑ Gas Will there be central air 52. Outdoors........................
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 C_] Electricity 44 [ ] Yes 45 ��� No 53. Number of bedrooms..............
38 Coal
39 Other — Speci/y Will there be an elevotor7 54. Number of Full..........
s 46 Yes 47 'J No bathrooms
N Lr+ �� Partial.......
DEPT. Ov F BUILDING INSPECTIONS BUILDING ZO �g g
! ! 212 Main Street OO< '
Northampton, MA 01060 PERMIT <a
36 - 89&90-4 VALIDATION
Neil Homstead & Co. nc. ADD '1 �msE 'ad"o 303 63 i 249
APPLICANT ADDRESS
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO New Building (_) STORY Detached Garage N(UMBERNG OF
UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) Lot #4 Mpale Ridge ZONING
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 construction of a 2 car detached garage
VOLUME 576 sq. ft. ESTIMATED COST � 12�000'0o FEEMIT $ 28,80
(CUBIC/SQUARE FEET)
OWNER Same as Applicant
BUILDING E 7.
ADDRESS BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK ^ ASSESSORS O