25A-058 (3) .S
For ALL buildings within Fire District and for other buildings costing $10,000.00 or more,plans
and specifications must be submitted to the Inspector of Buildings for examination and approval.
If building is to be moved give details relative to proposed location as for a new building.
A pp lication for Permit to Build
LS!Northampton, Mass., ....... ,4�1.. '....��.......LS!....192L..
To the Inspector of Buildings:—
The undersigned hereby applies for a permit to build, move, alter, or repair, according to the
following specifications.-
1. Owner's name ....STS.P .IN.....E:...MQS.........................................................................................................................................
2. Owner's address . .��....��ASAIL....sr:.. ..(vn2T14A. ...1.. , ......Q.j.S? ? ................._..........................
3. Architect's name ..............................................................................................................................................
.....................................................
4. Builder's name ....... ........................................_............................_.....................................................................................
5. Builder's address ..................................................................................................................................................................................................
6. Location of Building. Street No. .................................................................................................... .
7. Is this a removal or new building.................::
8. If removal, from where ......=.................................................................................._.................................................................
9. What is the purpose of buildin ...A.��.M..d.v....!e!�. (A.C..n.�.�.........................2a.. .....Z t :.`... :..
10. Material of building r.4X6 4...................................................._..........................................._.........................................
11. If a dwelling, for how many families....76.....................................Number of rooms ..g.............................................
12. Is there to be a store in the building JI Q...................................................................................:........................................................
7
13. Size of building, No. of feet front ............`-...;No. of feet deep .........6.(.1........; No. of stories....................
14. Size of ell, No. of feet front ........................: No. of feet deep ........................; No. of feet high ...........»..............
15. Size of Lot ................................................................ ... .Feet Wide ..... ......5 Feet Deep .................................
16. How near the-line of street ................................................................................................................................... ......._.
....... ......................
17. How near the line adjoining lot. Right ...................................: Left....................................; Rear................._..............
18. Nearest building is ................................. feet in a...................................................... direction ......................................................
19. Material of the floor ..................................._.........................................................................._..........................................._.............................
20. Size of timbers, 1st ........................: 2nd ....._................. ; 3rd ........................; 4th ..............................; 5th ..............................
21. No. of feet span ........................................._............................. ; Distance on centers ........................................................
22. Will the building be erected on solid or filled land ....................................... . ...................................................................
23. What is the material of foundation 1910C...........................................................................: Footing ....._.................
24. Will the roof be flat or pitched ..........................................................: Covering....................»........................_....................
25. Heat; steam, hot water, furnace, stoves..........................................: Power oil burner ................................................
26. Fireplace ...X.................................................................: Insulation ...............................................................................................................
27. How many sinks ....` ....; Toilets ....Z...; Lavatories An...; Bathtubs..I....; Showers....:....; Settubs ..1.....
28. City Service; Water ..q.0........... Sewer ..YV............: Road Surface 692....... ; Sidewalk ..VZ1...........
29. Is lot on accepted street ...�.Cf...................................................................................................................................................................
30. Estimated cost (must be filled out) .1_2.Od:oO........................................................................................................................
Applicant agrees to give the Inspector of Buildings 24 hours' notice before lathing or
plastering this building. This building will conform to the requirements of the law.
Signature of applicant ........... ..... ..�°. »:�..................... ����.�....................... ..
No..............5 ..........._...........
REMARKS
..................................................................................................................................................................»........................................»......._.........................................
........................................................................... ..............................................................................................................................................................................I
................................................»................».......»...........................................................................................................................................................................................
PLOT PLAN
In accordance with Article XI of the Zoning Ordinance, an application for a ,
Zoning Permit must include a Plot Plan, The following characteristics of the
parcel must be shown.
1. Dimensions of the lot.
2. Locations and size of all, buildings.
3. Average finished grade of all structures existing and proposed.
4. Use of all buildings existing and proposed.
5. Set Backs as indicated on the enclosed plan. '
Abuttors Name
Lot Ito.
Lot Ug- Ft.
4-
Rear Yard
Abuttors Abuttors
Name Name
Lot No. Lot No.
If this is a 4. Sideyard. •� House + ,30 Sideya.rd ♦ If this is a
corner lot, write corner lot, write
In the name of the in' the name of the
other street.
other street.
+, +�
�T, w
� o X31
j Sot Back
o O
.Lot Ft.
ri nits
k� 1
Name of Street
Indicate location of garage or accessory buildings with a dashed line.
Indicate location of Sewer hook—up 0
List all past plans, applications, permits, variances etc. and corresponding dates that
have been processed by this office.
I certify that the enclosed application and plot plan are complete and correct.
Signature of Owner ate
PageNo. Lot No.
ZONING PERMIT
T! I T'o L D t
APPLICATION
Zoning Crdin�.Axe Secticri 10," 'k C ;!c Filc Tlo, 111ni, File
C.
Address el -S. 4 -O A e s--
Telephone
This section is to be fill cui out in -,ccord�tLce tl,e fIrl,
of Di:' cnsion"7_ 7-nd
Density Reg ations:. (Z, Al,'Tl 'L],, WT
Zoning TTOC Lot Front D,_. t.I I t b-c
11 -1: x.-B I d rain. 01).
21.,gLt r i c t Ar c a '.7 i t�I q, Fr'-,T"t Side_---
1 dq-- over. space
r e-s e n t Proposed
il,�,irk the a'p-pr 0 p r i n t e box t J ri d i c t,e t,,, of T.C
1,7011-Gonforminp, L(�,It
Re--id,,ntj-,,l iiii-LI.. =1'u1ti.-Fvii1y
Du r,I e,.-,.: Q0thei
Business
Industrial
Institu t1 )-,I
Subdivision
Su b d i vi s i o i,i with "A
Poax,(!
Z011iDr, ROard APprov,-1 (Spcci,�l Per?.Iit V-ri,-,3 C
= City Council
(Special rxcr-pti.orl
WatersIted Protection District Overl i,,y c c t Y o
Parkins, Space Requirement.-: (Z.(,. .,sect.
Loading Space Requirement,-: (Z.(,. 'Cct. 802) ReqrircO-Propoced
Signs: (Z.O. Art. VII) Yec T,o
..Environmental Performance -,tandard:7�:
( Z,Q, Art. XJ1) -
Plot Plan Ye r, 0 i t C Plan y e 1,C,
(S. 10.2)
10.E ?nd
This scction for OFFICIAL u-,•e only:
=Approval qs preceijtn(I:
=140difications necessary for -1Pj)j'0V'11:
Re-turn: (Norc irforin-il-inr, 11cf-IC(l)
Denial: R(,,-sons:
Signature of Ap,,lic-in t Date ,)f P,.Imin. Officer Date
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