17B-008 (8) Vill. ZONING PLAN EXAMINERS NOTES
FRONT YARD
SIDE YARD SIDE YARD
IX. SITE OR PLOT PLAN For Applicant Use
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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.
T:
Owner or
Lessee r1`�Cf kc) S
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 f pplicant Address Application date
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
q Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL Is
OTHER Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Obta
Date in Number By Permit or Approval Check Date
ed 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
VII. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building /,� ` Use Group
Permit issued (� 19
Building Fire Grading
Permit Fee $ � C' C� Live Loading
Certificate of Occupancy $ Occupancy Load
Approv by: �--�
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
g+ MASSACHUSETTS
e OFFICE of the INSPECTOR of BUILDINGS
Page 1`� Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
L� ZONING
(• AT (LOCATION) ��%7>17 DISTRICT
LOCATION ��.t• e-(NO.) (STREET)
OF BETWEEN l r' S'T'n(ti.7 1 ':'A . AND .. `�1� (51 , M, �
BUILDING (CROSS STREET) (CROSS STRE ) —�
LOT /��??��
SUBDIVISION LOT BLOCK SIZE ` S'e-li rs
H
Ii. TYPE AND COST OF BUILDING — All applicants complete Parts A — D —�
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use r^
M
1 ❑ New building Residential Nonresidential
2❑ Addition(If residential, enter number 12❑ One family 18 E] Amusement, recreational
of new bousing units added, if any,
in Part D, 13) 13 ❑ Two or more family - Enter 19❑� Church, other religious
�Cj yJ'N(, number of units- - - - -i" 20❑J Industrial
3 Alteration (See 2 above)-/"�� `t 14 Transient hotel, motel,
21 Parking garage
4❑ Repair, replacement or dormitory - Enter number
5 ❑ Wrecking (If 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 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP ` i 27❑ Stores, mercantile
8 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,,•,,,,,,,,,,,,• l 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 $
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 ❑ Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34her - Specify 42 ❑ Public or private company 50. Total land area, sq. ft. ...........
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
[�)Sta IrLt; 1 R-k'A't-L_-b PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed .......................
35 Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 ❑ Yes 45 L, No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other - Specify Will there be an elevator? 54. Number of Full..........
46
[-1 Yes 47 D No bathrooms Partial........
DEPT. OF BUILDING INSPECTIONS BUILDING Z°
212 Main Street 0
Northamppton, MA 01060 PERMIT 2 IL
17/ D 8 VALIDATION
DATE Apri 1 22, 19 RR PERMIT NO. 224
APPLICANT 1Pff HI)trhinc ADDRESS d.aFi Rr1.dge Road 9141°,,�—
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO A1tPration (_) STORY nue fami \/ DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 44 Rri[qP Rnarl ZONING
Fi R
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: Parmi:1; t_ Q h A I,ddPEk/e
AREA OR 1 , 150.00 PERMIT 10.00
VOLUME ESTIMATED COST $ FEE s
(CUBIC/SQUARE FEET)
OWNER A?4 wHtehins UILDI a
ADDRESS B
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY ^ APPLICANT COPY • PINK - ASSESSORS COPY p*NT IIP