28-009 (5) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
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BOCA FORM APEBP — 669 01969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
O /
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 of ppliiccant Address Application date
D0 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
Fee Started y Approved y
BUILDING
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approva I Check Dote Number By Permit or Pit Approval I Check Date Number B
Obtained pp 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 FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued t �� 19 747
Building Fire Grading
Permit Fee $ � Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
V
NOTES and Data — (For department use)
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 PLAN EXAMINATION AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. 0
ZONING
I• AT (LOCATION) 1 DISTRICT
LOCATION (NO.) !STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
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 Im
M
1 ❑ New building Residential Nonresidential
2 �Addition(If residential, enter number 12XOne 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 22 ❑ Service station, repair garage
5 ❑ Wrecking (If multifamily residential, of units ——————— — -i
enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional
Part D, 13) ❑
16 Carport 24❑ Office, bank, professional
6 E] Moving (relocation) p fy ❑
17 Other — Se 25 Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. ORSHIP t�i.�.,�.L� TAL) 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••••••,,•••••... 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 $ 7i
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
34❑ Other — Specify 42 ❑ Public or private company 50. Total land area, sq. ft. ...........
43�Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. T E OF MECHA ICAL 51. Enclosed .......................
35❑ Gas Will ere be centr air 52. Outdoors........................
36JR Oil conditi ing?
L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 ❑ Yes 45 ❑ No 53. Number of bedrooms..............
38 ❑ Coal
39❑ Other — Specify Will there b an elev or? Full..........
54. Number of
46 ❑ es 47 No bathrooms
Partial.......
/__ 111 1 all
I
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 hi's
authorized agent.
SIGNATURE OF AGENT °
ADDRESS
(NUMBER) (STREET) (CITYi
APPROVED BY TITLE
DATE 19
i
DEPT. PILE COPY
Zp
DEPARTMENT OF BUILDING INSPECTIONS BUILDING
as
212 MAIN STREET
NORTHAMPTONO MA. 01060 PERMIT VALIDATION
28 - 9 Code #79
DATE Oetober 22, 19 79 PERMIT NO. 615
APPLICANT Kath= R Lin=er ADDRESS 320 Sylvester Road
(NO.) (STREET) (CONTR'S LICENSE)
1
PERMIT TO Wood stove ( 2 ) STORY Wood—burning NUMBER OF stove DWELLING U NITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) 32n Sylvester Road DISTRICT
(NO.) (STREET)
a BETWEEN AND
a
(CROSS STREET) (CROSS STREET)
LOT
IL SUBDIVISION LOT BLOCK SIZE
(O
0 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)
L, REMARKS: Ins a]j wood burning stove in existing chi>rm.ey ! No other source of heat Sri flue
AdV,;--,.d r6 pfArec7 �/Lu4w, = Wv ao Ar. �r t C°lsc�F w,ry Eua> r-�tc'� v C.1Nar.:a
09 ni rI eKi Ci
AREA OR PERMIT
VOLUME ESTIMATED COST . 400,00 FEE 10.00
(CUBIC/SQUARE FEET)
OWNER Wi l 11 am & Ka hrvn Li Tigner
BOIL
ADDRESS :nn g1 VP=4w°" RnA' Nnr1"harrm')'.nT) BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)