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17C-031 (4) ZONING • FRONT DISTRICT YARD SIDE YARD SIDE YARD REAR . , NOTES IX. 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IDENTIFICATION — To be completed by all applicants Name Mailing address — Number, street, city, and .State ZIP code � Tel. No. �C� ' f� l Owner or fL6"�fllY� CSr ©�CC�tCE' OS VVIIL �'�_ ^'tL3tii YS� Lessee �(C� Builder's 2. -rom 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. Sign re Fplicdnt dr Address Application date 7 44 )/ 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 $ V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approval Check ObDtaain d 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 II. VALIDATION Building FOR FOR DEPARTMENT USE ONLY Permit number �J'� Bui(ding. Use Group Permit issued 19�f Building Fire Grading Permit Fee $ Live Loading Certificate of Occupancy $ Occupancy Load Approved by: Drain Tile $ _ Plan Review Fee $ TITL — CITY OF NORTHAMPTON A �� MASSACHUSETTS OFFICE of the INSPECTOR of BUILDINGS '"' 4 Page Plot APPLICATION FOR ZONING PERMIT AND INSPECTOR BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: I, 11, HI, IV, and IX. O ZONING AT (LOCATION DISTRICT LOCATION N (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 1 ❑ New building Re idential Nonresidential 2 b El Addition(1/ residential, enter number 12 One family 18 ❑ Amusement, recreational of new housing units added, if any, in Part D, 13) 3 Two or more family — Enter 19 ❑ Church, other religious number of units— — — — > 20 ❑ Industrial Alteration (See 2 above) 14 l t l t t h i Transenoe , motel,❑ 21 ❑ Parking garage ❑ Repair, replacement or dormitory — Enter number 5 ❑ Wrecking (1l 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) 7 ❑ Foundation only 11 Other — Specify 25 ❑ Public utility ' / 26 ❑ School, library, other educational B. OWNERSHIP / 27 ❑ Stores, mercantile 8 Private (individual, corporation, /7 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,,,,,,,,,,,,,,,, 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 G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS 30�❑�/Masonry (wall bearing) 40Y Public or private company 48. Number of stories..... ........ 31 lu Wood 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. TYPE OF WATER SUPPLY 34 ❑ Other — Specify 4. Public or private company 50. Total land area, sq. ft. .......... 43 '❑ Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES F. PRI'�J IPAL 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 No 53. Number of bedrooms.............. 38 ❑ Coal 39 ❑ Other — .Specify Will there be an elevators Full.......... 54. Number of 46 F1 Yes 47 No bathrooms Partiol....... BUILDING n _ 3 PERMIT <a 12C � VALIDATION DATE � 19 ERMIT NO. L APPLICANT ADDRESS ( 0. (3 TREE T) (CONT R'S LICENSE) NUMBER OF PERMIT TO (_) STORY DWELLING UNITS - (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ZONING AT (LOCATION) ' DISTRICT (NO.) _. (5 EET) 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 i TO TYPE USE GROUP e4lrll BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS. L AREA OR ESTIMATED COST .$ FEEMIT VOLUME (CU IC/ UAR&FEET) OWNER BUILDING EP `ODRESS BY WHITE - FILE COPY • GREEN - FIELD COPY • CANARY - APPLICANT COPY PINK - ASSESSORS COPY