25C-057 (8) ZONING •
DISTRICT
FRONT YARD
IX. SITE OR •
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
1.
Owner or 31 Utz S�/
Lessee /1S n ) ^ t.Q A-) /k-t
Blui lder's !�O
2• 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.
Signature of applicant Address / 1 Application date
/
DO NOT WRITE BELOW THIS LINE
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 Is
OTHER Is
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number B Permit or Approval Check b B Date Number Obtained y pP Obtained Y
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 p _/ FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued Gvolyu _ 19
Building t Fire Grading
Permit Fee $ Live Loading
Certificate of Occupancy $ ( u ancy Load
Approved by• t
Drain Tile $
Plan Review Fee $
TITLE
' CITY OF NORTHAMPTON
�. .� MASSACHUSETTS
$ f OFFICE of the JXSPECTOR of BUILDINGS
T
Page — Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
4,..� ^ �� /►.�� ZONING
I• AT (LOCATION) DISTRICT(STREET)
LOCATION (NO.)
�/
/f 11 c i G AP
OF BETWEEN / ��C AND
BUILDING {CROSS S S STR TREET) (CR 55 57 REE7)
LOT
SUBDIVISION LOT BLOCK SIZE
to
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
1 New 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
5 El Wrecking (I/multifamily residential, of units ------- - --� 22 � Service station, repair garage
enter number of units in building in 15 L❑ Garage 23 �❑ Hospital, institutional
Part D, 13) 16 ❑ Carport 24 bank, professional
6 ❑ Moving (relocation) b
17 F1 Other - Specify ta (f�' 25 r Public utility
7 ❑ Foundation only 26 r❑ School, library, other educational
B. OWNERSHIP GV� � " 27 L❑ Stores, mercantile
8 Private (individual, corporation, 28❑ Tanks, towers
nonprofit institution, etc.) 29❑ Other - Specify
90 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................ SOU 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 Is
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
48. Number of stories...............
30❑ Masonry (wall bearing) 40 L❑ Public or private company
41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area,
31 ❑ Wood frame p all floors, based on exterior
32❑ Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
42 ❑ Public or private company 50. Total land area, sq. ft. ...........
34 ❑ Other - Specify _
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning.' L. RESIDENTIAL BUILDINGS ONLY
37 CJ Electricity 44 ❑ Yes 45 ��'I No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other - Specify Will there be an elevators 54. Number of Full..........
46 ❑ Yes 47 No bathrooms
Partial.......
a DEPT. OF BUILDING INSPECTIONS BUILDING
212 Main Street OO<
Northampton, MA 01060 PERMIT
25C - 57 VALIDATION
DATE j jlp 17 19 J37 PERMIT NO. 38�
APPLICANT ADDRESS � � n�B -- �-
0.) (8 (CON S IC NSE)
Above Ground Pool One Famil y NUMBER OF
PERMIT TO (,) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
31 Lincoln Ave. ZONING URB
AT (LOCATION) 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 installation of an above ground pool 24' diameter
AREA VOLUME ESTIMATED COST � 1 ,500.00 PER 10.00
(CUBIC/SQUARE FEET)
OWNER Same as Applicants BUILDIN T �
ADDRESS Same as Applicant's 8Y
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pjNf P