25A-135 (3) ZONING •
DISTRICT
FRONT USE
SIDE •D SIDE
REAR YARD
NOTES
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NOTES and Data — (For department use)
7
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, anr( State PIP code i, Tel. No.
1. 1 —
Owner or
Lessee
9/I ,� r �� Builder's
1.
,v I� License No.
Contractor t
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.
Signature of applicant Address Application date
T
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re wired Check Plan Review Date Plans By Plans B Notes
9 Fee Started y Approved y
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 Use Group
Permit issued Ll Z4 19 _
Building
Fire Grading
Permit Fee $ 3�- �D Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $ G'
s
INZU-
CITY OF NORTHAMPTON
MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page Plot ZJJ APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 11, 11, 111, IV, and IX. O
I• AT (LOCATION) +CLc�.,�, ..'/� �! DISTRICT
LOCATION (N 0.) (STREET
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
V1
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
—f
1 ❑ New building Resi al Nonresidential
2 ❑ Addition(If residential, enter number 12 One family 18 Amusement, recreational
of neu, housing units added, if any,
z art D, 13) 13 ❑ Two or more family — Enter 19 �❑ Church, other religious
number of units— — — — --> 20 �❑ Industrial
3 Alteration (See 2 above) 14 l
l
h
i
Transent hotel, mote ,
❑ 21 Parking garage
4 ❑ Repair, replacement or dormitory — Enter 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 ❑ Moving (relocation)
❑ 17 ❑ Other — SpeciJy 25 �❑ Public utility
7 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
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement...............• UVAO 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 L
a. Electrical..................... . '�-
b. Plumbing .....................
c. Heating, air conditioning.......... `
d. Other (elevator, etc.)............. r *�
11. TOTAL COST OF IMPROVEMENT $ zwo
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 L Public or private company 48• Number of stories...............
31 �ood Frame 41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 ❑ Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYP CAF WATER SUPPLY
34 ❑ Other — Specify 42 or private company 50. Total land area, sq. ft. ...........
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. 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 ff Yes 45 No
L❑ - 53. Number of bedrooms.............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevators Full..........
54. Number of
46 ❑ Yes 47 No bathrooms
Partial......
w
i �
'tiA.'
�..
Iepartment of Building Inspections
za
;12 Main 9trTet BUILDING
Iorthampton.00a, OW60 PERMIT is
25A - 135 VALIDATION
DATE August 12. 19 82 PERMIT NO. 376
APPLICANT Philip Ahearn ADDRESS 144 Federal
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Alteration ( 7 STORY kitchen rEIIOV - Iky'IOt DWELLING UNITS 1 -
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE
ZONINGS
AT (LOCATION) 17 Glenwood Avenue _ DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (GROSS 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: Rennvnte kitchen. instal], gkyl gbt remove wall- atart nosmatic changes
AREA OR PERMIT � '4L On
VOLUME
ESTIMATED COST � 9,000 FEE �s+�
(CUBIC/SQUARE FEET)
OWNER TAm Hay wned BUILDING EPT
01060
ADDRESS 17 Glenwood Avenue, Northampton, Ma. BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY