25C-111 (3) ZONING •
DISTRICT
FRONT YARD
SIDE YARD SIXE • .
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NOTES and Data — (For department use)
x
/ f
IV. IDENTIFICATION — To be completed by all applicants d
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
Owner or
Lessee
Bui Ider's
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.
,Signc,tur of applicant Address Application dat /1
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
ae Date
Permit or Approval Check ObDtaTned 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 DEPARTMENT USE ONLY
Permit number
Bul Iding Use Group
Permit issued � �� 19
Building
Fire Grading
e,
Permit Fee $ �Q'G'� Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
e OFFICE of the INSPECTOR of BUILDINGS
Page Plot &Z
APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. 0
ZONING
AT (LOCATION) j
LOCATION ("O•) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
(^
II. T)'PE 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 Res'd tial Nonresidential
2 �] Addition(If residential, enter number 12 One family 18 ❑ Amusement, recreational
of new bousing units added, if any,
in Part D, 13) 13 F-1 Two or more family - Enter 19 ❑ Church, other religious
number of units- - - - -� 20 ❑ Industrial
3 [YAlteration (See 2 above) 14 t
h
i
�l Transent hotel, motel,
L--1 21 ❑ Parking garage
4 Repair, replacement or dormitory - Enter number
5 Wrecking (If multifamily residential, of units- ------- - -f 22 Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional
Part D, 13)
T6 Carport 24 ❑ Office, bank, professional
6 Moving (relocation)
17 Other - Specify 25 ❑ Public utility
7 Foundation only
26 ❑ School, library, other educational
B. O'VNERSHIP 7 L❑ Stores, mercantile
8�< Private (individual, corporation, r 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
ti). 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.).............
/ f
11. TOTAL COST OF IMPROVEMENT $ (s'G
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 Public or private company 48. Number of stories.......
31 Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 L❑ Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPk OF WATER SUPPLY
34 ❑ Other - .Specify 42 �Ji�ublic or private company 50. Total land area, sq. ft. ..........
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 L Gas Will there be central air 52. Outdoors........................
36 TIJ�-rJJ/Oil conditioning?
L. RESIDENTIAL BUILDING,�.L;NLY
37 ❑ Electricity 44E]l Yes No
53. Number of bedrooms.�,�,/.......
38 ❑ Coal /
39 L_] Other - Specify Will there be an elevator? Full...F.....
54. Number of
46 ❑ Yes 47At4 o bathrooms
Partial........
I hereby certify that the proposed work is authorized by the owner of record
and I have been authorized by the owner to make this application as Ks
authorized agent.
SIGNATURE OF AdNT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
DEPARTMENT OF BUILDING INSPECTIONS DEPT. FILE COPY
zO
212 MAIN STREET O<
NORTHAMPTON, MA. 01060 BUILDING P a a
25C - 111 • ERMIT VALIDATION
DATE Sept- 15" 19 Rn PERMIT NO. 489
APPLICANT PBtrie-ja W. wilplAnd ADDRESS_A6 Grant ASre.
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO 27irnneV. stave _ (1_) STORY
For 1yAAf�..POST inQ_gtorea DWELLING UNITS 1
(TYPE OF MPROVEMENT) NO. (PROPOSED USE
Ave, ZONING
46 Grant
AT (LOCATION) DISTRICT TTRB
(NO.) (STREET)
a BETWEEN ND
io (CROSS STREET) (CROSS STREET)
a
LOT
IL SUBDIVISION LOT B\CK SIZE
m
u BUILDING IS TO BE FT. WIDE BY FT. L G T. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m &,/..- J
Z TO TYPE USE GROUP S ENT WALItS OA�FOUNDATION
f (TYPE)
O:
0
IL REMARKS: ron n tru r-t intpriar�IsLry chimney and install mod stoyee
PERMIT
AREA OR ESTIMATED COST $ in nn 00 An VOLUME �-�--
(CUBIC/SQUARE FEET)
OWNER Patricia W Wieland BUILDING DEPT A t))IIW
ADDRESS 46 Grant Ave., N'ton. , Ma. 01060 BY
(Affidavit on reverse side of application to be completed by authorize agent of owner)
,r
INSPECTION RECORD
DATE NOTE PROGRESS - CRITICISMS AND REMARKS INSPECTOR
DEPARTMENT OF BUILDING IBSPBCTINS
FIELD COPY
212 MAIN STREET
NORTHAMM9 MA. 01060 BUILDING
25C _ �s2 PERMIT
DATE Sept ZS 19 80 PERMIT NO. 6.89
APPLICANT Patricia W Wieland ADDRESS 14i cra"t kys
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO C�3�li leY ae stBV@ (2-) STORY FAT 00641-hUlrniliQ !tOT& DWELLING UNITS 1
(TYPE OF IMPROVEMENT) NO. (PROPOSED USEf
ZONING
AT (LOCATION) 46 Grant Aye DISTRICT URA
(NO.) (STREET)
rn BETWEEN AND
o (CROSS STREET) (CROSS STREET)
rn
- LOT
IL SUBDIVISION LOT BLOCK SIZE
m
U BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
0:
L, $"!ta 'REMARKS: Construct interiar mas()nary chimney °"'_ ��� a ^�
_ PERMIT $�
AREA OR ESTIMATED COST . FEE ".] nn
VOLUME
(CUBIC/SQUARE FEET)
Patricia W Wieland yf
OWNER P
BUILDIN DE
ADDRESS 46 Grant Ave,,, 114 y tau&t MS• 01060 BY -�''
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