25C-147 (3) Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
Owner or t �ll/ fi ///i <..
Lessee
/ 1 Bui Ider's
2. f rCrl, t "1 j �/Ci�it _�7 � � �V/7 `� f 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 Application date
00 NOT WRITE BELOW AT HIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date P y Ions B Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number By Permit or Approval Check Date Number B
Obtained Obtained 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 All Permit number FOR DEPARTMENT USE ONLY
Building. �(_ Use Group
Permit issued 19
Building n Fire Grading
Permit Fee $ eft/ Live Loading
Certificate of Occupancy $ Occupancy Load
Appr y:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
e OFFICE of th INSPEC;TOR of BUILDINGS
Page Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all/items 7in sections: 1, 11, 111, IV, and IX. O
ZONING
(• AT (LOCATION) 5� / J DIISTR CTI(�
LOCATION (NO.) (STREET)
OF BETWEEN_ AND
BUILDING CROSS STREET) CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vr
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 Residential Nonresidential
2 Addition(IJ residential, enter number 12 � 0 e family 18 Amusement, recreational
of new housing units added, if any, 13 Vwo or more family — Enter 19 Church, other religious
n Part D, 13) number of units-- — — —
3 Alteration (See 2 above) 21 Industrial
14 � Transient hotel, motel, 21 Parking garage
4 D Repair, replacement or dormitory — Enter number 22 Service station, repair garage
5 _ Wrecking (11 multifamily residential, of units ——————— —
--�
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 17 �� Other — Specify_ 25 � Public utility
26 School, library, other educational
B. OWNERSHIP _ 27 Stores, mercantile
8 Et,J"' rivate (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 Other — Specify
9 D 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 cfj If use of existing building is being changed, enter proposed use.
in the above cost
a. Electrical....................... /E IC �t�
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 Parris F - 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 CJ Public or private company 48. Number of stories..............
31 Wood frame 41 F-1 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 42 [7] Public or private company 50, Total land area, sq. t. ..........
43 L-7 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 Electricity 44 ) Yes 45 i.. No 53. Number of bedrooms..............
38 G Coal
39 L_� Other - Specify Will there be an elevator? Full..........
54. Number of
46 [-1 Yes 47 'Lj No bathrooms
- Partial.......
Department of Building Inspections
212 Main street
Northamtpon, Mass. 01060 BUILDING
PERMIT
X%XXX 25C - 147
VALIDATION
DATE April 30, )y 84 PERMIT NO. 165
APPLICANT Diggins & Worden ADDRESS %%XXO 59 Conz Street 014271
IN 0.) (STREET) (CONTR'S LICENSE)
PERMIT TO Alteration (_) STORY existing 2 family home NUMBER NG UNITS _
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
27 Orchard Street 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 to make minor renovations to kitchen and bathroom also add a second means of
egress.
AREA OR 10 100.00 PERMIT 36.00
VOLUME ESTIMATED COST $ FEE
(CUBIC/SQUARE FEET)
OWNER Lionel Cullen
rc ar ree , or amp on, as BUILDI
ADDRESS BY
WHITE - FILE COPY • GREEN - FIELD COPY ■ CANARY - APPLICANT COPY a PINK - ASSESSORS COPY