32A-247 (6) • r
• For ALL buildings within Fire District and for other buildings costing$10,000.00 or more,plans
fLnd specifications must be submitted to the Inspector of Buildings for examination and approval.
If building is to be moved give details relative to proposed location as for a new building.
1 --- uJ(2 A
Application for Permit to Build
f y
Northampton, Mass., ........�. ��:��'.� ...•.19..7..1...»
To the Inspector of Buildings:—
The undersigned hereby applies for a permit to build, move, alter, or repair, according to the
following specifications.—
1. Owner's name ....»........».......».......»....».»:...»...................................:»............._....»....».».........._......»......................._...................._...._..........
2. Owner's address ...................................I..........._...............------».
----.------..................................................................................».»........
3. Architect's name .......................»...................»..»»..........................»...._.......».............»..........».».....................................................................
4. Builder's name ............................................................................................................................................................................................
5. Builder's address ...............».........................................................................................................................................................................
6. Location of Building. Street No. ........................»........._.»............................_................................................................_.».......»...»..
7. Is this a removal or new building..............»........................_...........................................................................:......».;......a..............°
8. If removal, from where ............._............_.. ••»•• •••
9. What is the purpose of building ................6........3 . 4>....:..w ....: » » s....».. �..
10. Material of building ................................»..... .�.z.........�..a .............±.......»....»..................................
11. If a dwelling, for how many families............... ............................Number of rooms ...................................................
12. Is there to be a store in the building ...........».......................»...............................».......»...........:.......»..»............_...............»...........
13. Size of building, No. of feet front ........»»...........;No. of feet deep ......................; No. of stories..........»....»..
14. Size of ell, No. of feet front........................: No. of feet deep ................._.....; No. of feet high .........................
15. Size of Lot .....».»....».................................».»......._....................Feet Wide ............................... Feet Deep ............................»..
16. How near the-line of street ...................................................................»........................................».............................................._.».....
17. How near the line adjoining lot. Right................._................; Left...................................; Rear................................
18. Nearest building is ................................ feet in a...................................................... direction ......................................................
19. Material of the floor ...................................
20. Size of timbers, 1st ..........._..........; 2nd ....._.........._..... ; 3rd .......................; 4th .............................; 5th .....................».....
21. No. of feet span.»................................................................ ; Distance on centers ....................................................................
22. Will the building be erected on solid or filled land ............................»......................................................................».....
23. What is the material of foundation.....»....».»...................»....».......»....»....».........................._....; Footing ....._................
24. Will the roof be flat or pitched ...........».»....»........................................; Covering..............................................................».
25. Heat; steam, hot water, furnace, stoves.......................................; Power oil burner .....»......................_...._.......»..
26. Fireplace .....».............».............»..........»......................; Insulation .......................................................»..........»...................................._..
27. How many sinks ............: Toilets .....».....; Lavatories ..».....; Bathtubs....»..; Showers............; Settubs.........
28.
29.
30.
City Service; Water ....................... Sewer .......................; Road Surface ...................._.....; Sidewalk .................».....
Is lot on accepted street ........................
Estimated cost (must be filled out)
Applicant agrees to give the Inspector of Buildings 24 hours' notice before lathing or
plastering this building. This building will conform to the requirements of the law.
�'Ct1AMP�'
CITY OF NORTHAMPTON
ZQNING PERMIT APPLICATION a Tax Map No. Lot
Zoning Ordinance Section 10.2 Received: File No. Plan File
Owner Applicant
Address - 1� Address ✓ , lei �''"''� Owl
Telephone Telephone
This section is to be filled out in accordance with the "Table of Dimensional and Density Regulations:
(Z.O. ARTICLE VI)
Zoning Use Lot Front Depth Setbacks Max. Bid. Min. Op.
District Area Width Front Side Rear Cover Space
Past Existing % %
claI4
Present Proposed
Mark the appropriate box to indicate the use of the parcel:
❑ Non-Conforming Lot and/or Structure. Specify
IKResidential ❑Single Family Unit ❑Multi-Family
❑ Duplex ❑ Other
❑ Business
❑ Individual
❑ Institutional
El Regular ❑ P.U.D.
❑ Subdivision ❑ Cluster ❑ Other
❑ Subdivision with "Approval-Not-Required"-Stamp:
❑ Planning Board Approval:
❑ Zoning Board Approval (Special Permit 10.9: Variance)
❑ City Council (Special Exception S. 10.10)
Watershed Protection District Overlay: (Z.O. Sect. XIV) ❑ Yes ❑ No
Parking Space Requirements: (Z.O. Sect. 8.1) Required Proposed
Loading Space Requirements: (Z.O. Sect. 8.2) Required Proposed
Signs: (Z.O. Art. VII) ❑ Yes ❑ No
Environmental Performance Standards: (Z.O. Art. XI 1) ❑ Yes ❑ No
Plot Plan ❑ Yes ❑ No Site Plan ❑ Yes ❑ No
(S. 10.2) (S. 10.2 and 10.11
Waiver Granted: Date ❑
This section for OFFICIAL use only:
K Approval as presented:
❑ Modifications necessary for approval:
❑ Return: (More information needed)
❑ Denial: Reasons:
,,%t6nalure of Applicant Date Signature of Ad in. Officer Date
THE PRINTING PRE55
hereby certify that the proposed work is authorized 'by the"owIner`of" record
and I have been authorized by the owner to make this application as his •'
authorized agent.
SIGNATURE OF AGENT ' >_.,.
ADDRESS . = .
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
DEPT. PILE COPY
Z0
CITY OF NORTHAMPTON BUILDING a D-
NORTHAMPTON, m. oto6o PERMIT
VALIDATION
•
DATE June 21T 19 _ PERMIT NO. 2:5i
APPLICANT Lan I ghApard ADDRESS_ ),?NOT-hh
(S TREET)r -1-m$ Bza (coN7R s LICENSE)
NUMBER OF
PERMIT TO w3 11i 7i�gt'jp (—) STORY T9A}i0 DWELLING UNITS
__-(_-T Y__PEEPOF IMPROVEMENT) N0. (PROPOSED USE)
I
A ZONING
AT (LOCATION) rair DISTRICT
�Q UR�
(N0.) (STREET)
a BETWEEN AND
a (CROSS STREET) (CROSS STREET)
LOT
a SUBDIVISION LOT BLOCK SIZE
m
t
U
O BUILDING IS TO BE FT. WIDE BY FT..LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
f (TYPE)
Ir
O
LL REMARKS:
AREA OR ESTIMATED COST $ 3,500.00 FEE
MIT
VOLUME $J!•00
(CUBIC/SQUARE FEET)
OWNER Stanley }'awski BUI �' �
ADDRESS 39 ftir q ree No— hsmyton BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)
NNW