17B-008 (10) - Vill.-ZONING PLAN EXAMINERS NOTES
DISTRICT
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name / f' /Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or /fl/t`[t �. �t lCf9i/VS l�f/0� N/r' O/t� /� ✓' /f /evOC/os IQIL� ��dV 6 0 -S; J�
Lessee
Builder's
2. S/Gr�� 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 f Address Application date
00 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
Permit or Approva I Check Date Number By Permit or Approval Check Number I Chk Date Nb 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
VII. VALIDATION
Building j� FOR DEPARTMENT USE ONLY
Permit number
Bui Iding Use Group
Permit issued �,� i . 19
Building f Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $ r
Plan Review Fee
TITLE
CITY OF NORTHAMPTON
�. .� - MASSACHUSETTS
r •
$ OFFICE of the SPECTOR of B ILDINGS
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
ZONING
AT I• AT (LOCATION) DISTRICT
LOCATION (NO') (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT /J
SUBDIVISION LOT BLOCK SIZE
N
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 F__1 New building Residential Nonresidential
2 Addition(If residential, enter number 12F ] One family 18 ❑ Amusement, recreational
of new housing units added, if any, 13 [�Two or more family — Enter 19 Church, other religious
in Part D, 13)
number of units— 20 Industrial
3 Alteration (See 2 above)
14 Transient hotel, motel, 21 parking garage
4 0 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 L� Garage 23 Hospital, institutional
Part D, 13) 24 Office, bank, professional
6 � Moving (relocation) 16 � Carport
17 ❑ Other - Specify 25 ❑ Public utility
7 Foundation only 26 School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 eIPrivate (individual, corporation, 28❑ Tanks, towers
nonprofit institution, etc.) 29 Other - Specify
9 ❑ Public (Federal, State, or
local government)
C. COST ( 70 cents) anresidential — Describe in detail proposed use of buildings, e.g., food
6r4— pr cessing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,•........., �d s ool, secondary school, college, parochial school, parking garage for.
epartment 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 6 O
a. Electrical.....................
b. Plumbing ..................... 02-1
C'. Heating, air conditioning..........
d. Other(elevator, etc.)............. /�
11. TOTAL COST OF IMPROVEMENT $ (J o
Ili. SELECTED CHARACTERISTICS OF 9UILDING — 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 D Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 F__1 Structural steel dimensions ..................... d
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 Other — Specify 42 ePublic 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 dGas Will there be central air 52. Outdoors........................
conditioning?36 a Oil c g L. RESIDENTIAL BUILDINGS ONLY /
37 Electricity 44 [_ Yes 45 Imo/' No 53. Number of bedrooms..............
38 Coal /
39 Other - Specify Will there be an elevators 54. Number of Full.......... I
—
46 n Yes 47 �No bathrooms
Partial........
y DEPT. OF BUIL,OING INSPECTIONS BUILDING ZO
a 212 Main Street 0 IL
Northampton, MA 01060 PERMIT
17B _ g VALIDATION
October 20,
DATE �9 PEr IT No. 710
APPLICANT
James 1. Hutchins ADDRESS Ltastri�rgton HVe. Owner(NO.) (STREET) IC QNT R'S LICENSE)
Addition Existing 2 Family NUMBER OF
PERMIT TO (_I STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
Bridge Road ZONING RK
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 an addition of extra living space onto existing two family dwelling
Per LBA Approval
AREA OR 850 sq. ft. ESTIMATED COST $ 9,000.00 PERMIT $ 16.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER Same as Applicant
ADDRESS
ame d$ Applicant's BYI D T.tz
WHITE - FILE COPY . GREEN - FIELD COPY a CANARY - APPLICANT COPY • PINK ASSESSORS COPY QP