25C-027 (5) Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
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SIDE YARD SIDE YARD
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NOTES and Data — (For department use)
r
_6
WT ci
IV. IDENTIFICATION To be completed by all applicants
Name Mailing address Number, street, city, and State ZIP code Tel. No.
Owner or I L
Lessee
r Build
2. License e N..
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.
Signott�reof applicant Address Application do I te
A<7 �LL r -e --
>
00 NOT W R I T E BELOW T H I S L I N E
V. PLAN REVIEW RECORD For office use
Plan Review Date Plans Date Plans
Plans Review Required Check Fee Started By Approved By Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date D
Permit or Approval Check Obtained Number By Permit or Approval Check Obtai ate ned 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
V11. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number 79112
Building T Use Group
Permit issued n,_ 0,0- - C-� t 19.
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 I SPECTOR of BUILDINGS
T
Page Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. C)
ZONING
I•
VO
AT (LOCATION) / i- DISTRIC
LOCATION (NO') (STREET)
OF BETWEEN I..~' 'w.-\--�1-t. 1 /A AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D ;0
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
m
1 New building Residential Nonresidential
2 Addition(1/residential, enter number 12 'One family 18 ❑ Amusement, recreational
of new housing units added, if any, }L—�
. Part D, 13) 13 Two or more family — Enter 19 ❑ Church, other religious
number of units— — — — -i 20❑ Industrial
3 Alteration (See 2 above)
14 ❑ Transient hotel, motel, 21 Cl Parking garage
4 Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (11 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 — Speci/y 25 ❑ Public utility
7 n Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8'Q 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••••,••,,....... (- 'I�% 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 $ 5/ w,_
III. SELECTED CHARACTERISTICS OF BUILDICNG�( — 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,T5�T Public or private company 48. Number of stories.........
49
31 Wood frame. 41 [::] Private (septic tank, etc.) . Total square feet floor area,
all floors, based on exterior
32 ❑ Structural steel dimensions
.....................
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other — Specify 42Public or private company 50. Total land area, sq. ft. ..........
N�
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL 1. TYPE OF MECHANICAL
35 Gas Will there be central air 52. Outdoors........................ _
conditioning?
36� Oil L. RESIDENTIAL BUILDINGS ONLY
37 CJ Electricity 44 ❑ Yes 45 N 0 53. Number of bedrooms.............. `
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevator? Full..........
_ 54. Number of
46 [ Yes 47 ' ',a7N o bathrooms _
Partial.......
.a DEPT. OF BUILDING INSPECTIONS Z�
► • 212 Main Street
BUILDING 0a
Northampton, MA 01060
PERMIT
2J4 w 27 VALIDATION
DATE blece,,bc-r 2. 19 t� PERMIT NO. 706
APPLICANT illobort iipckman _ ADDRESS *f1 :1P 'V i co C.F'•n-tp'c ?n:id )±}'� i� '•.
(NO.) (STREET) (CONTR'S LICENSE)
l�. NUMBER OF
PERMIT TO Add il_1f)il� I'r_€a1 _!)1(i➢i1(°t�YIn$TORY 1f0 h �)i7� DWELLING UNITS
(TYPE OF IMPROVEMENT) N0. ` (PROPOSED U9 )
ZONING
AT (LOCATION) n2 N'arth'°'rn Ayp - 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
q �1 a (TYPE)
REMARKS: pnri f i t' P"4Y' `�hif Find i t i nn of A LY)--A jai "i wn C'`:'or_y
d1delllnc, remodeling .y .oa.-hs ; and Ciit31ing <Ia=^c"-ge to cppusiv,1 s".dQ of dw—e 17.:;
z 2
s0� 00 PERMIT $AREA OR ad(3-'i i o ESTIMATED COST
VOLUME u FEE
(CUBIC/SQUARE FEET)
� wrs L� Hat{'cltry
OWNER BUIL ,
ADDRESS
WHITE - FILE COPY GREEN - FIELD COPY CANARY - APPLICANT COPY ■ PINK - ASSESSO S COPY P}xT' IP