25C-187 (7) ZONING •
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT
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NOTES and Data — (For department use)
t
IV. IDENTIFICATION — To be completed by all applicants
r
Name Mailing address — Number, street, city, anti State ZIP code Tel. No.
1. A 6 •�
Owner or
Lessee
Builder'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.
Signature A applicant .__ Address Application date
D0 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Dote
Permit or Approval Check Obta ned 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 DEPARTMENT USE ONLY
Permit number .�
Building_ /) 3 19�— Use Group
Permit issued ( ,
Building
Fire Grading
`/Permit Fee $ A Live Loading
Certificate of Occupancy $ Occupancy Load
p ved by:
Drain Tile $
G
Plan Review Fee $
TITLE
(o CITY OF NORTHAMPTON
9` MASSACHUSETTS
e OFFICE of the INSPECTOR of BUILDINGS
Page dgq`S-C' Plot / O APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O
ZONING U
I• AT (LOCATION) , DISTRICT
LOCATION (RO.) `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 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 ❑ 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) ❑
16 Carport 24 ❑ Office, bank, professional
6 ❑ Moving (relocation)
1�7�❑ Other — SpeciJy 25 ❑ Public utility
7 ❑ Foundation only Q� /
26 ❑ School, library, other educational
K,
B. OWNERSHIP B. ❑ Stores, mercantile
8 Private (individual, corporation, / 28 ❑ Tanks, towers
Tl nonprofit institution, etc.) �(�•.e 29 ❑ Other — Specify
9 ❑ Public (Federal, State, or All
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,,,,,,,,,••,•.•. �6Q•d` 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.)............. J
11. TOTAL COST OF IMPROVEMENT $ . OV
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 t
30 Masonry (wall bearing) 40 Public or private company 48. Number of stories................
�`L/
31 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
50. Total land area, sq. ft. ..
34 ❑ Other — .Specify 42 � Public or private company ""
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed .......................
5 LJ Gas Will th a be central air 52. Outdoors........................
3
Oil condition g?
L. RESIDENTIAL BUILDINGS ONLY
IL_�
37 � j Electricity 44 Yes 45 No 53. Number of bedrooms..............
38 Coal
39 i _� Other — Spccify Will there be an elevator? Full..........
54. Number of
46 }'Yes 47 I❑ No bathrooms
Partial.......
INSPECTION RECORD
DATE NOTE PROGRESS - CRITICISMS AND REMARKS INSPECTOR
///7 �S�
FIELD COPY
DSPARTNUT OF BUILDING rN SPECTIONS
212 MM STRZET BUILDING
WRTHWTON q MA. 01060
PERMIT
25C - 187 +
DATE October 22p 19 80 PERMIT NO. 639 j
APPLICANT R*11&3 W. Batten ADDRESS 28 Highband Ave,
(N0.) (STREET) (CONTR'S LICENSE) j
NUMBER OF
PERMIT TO Chimney & coal stove ( Lh ) STORY For cog!-burbling stove DWELLING UNITS 2 ;
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
28 Highland Ave. DISTRICT URC
AT (LOCATION)
(NO.) (STREET) j
rn BETWEEN AND
�o (CROSS STREET) (CROSS STREET)
rn
LOT
IL SUBDIVISION LOT BLOCK SIZE
m
i
u O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION I
�
0
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
0 REMARKS: New block chinmey & coal burning store
it
t1 i
VOLUME ESTIMATED COST . 900.0 FEEMIT �+ 10.00
(CUBIC/SQUARE FEET) ,P i
1 i
OWNER Ro!!as W. Bath BU
28 Highland Ave. N'tou. Ma. 01060 B
ADDRESS �► • Y