28-033 (7) ZONING •
FRONT
SIDE YARD SIDE YARD
REAR YARD
IX. SITE OR PLOT
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NOTES and Data — (For deportment use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code 41. N
Owner or 010r 0
Lessee �/
2 Builder's
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 autho ized agent and we agree to conform to all applicable laws of this jurisdiction.
Signatur of applic 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 B Notes
Fee Started Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number B Permit or Approval I Check Date Number B
Obtained y 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 numberC�
Building f� Use Group
Permit issued �Q ICY , _ 19
Bui Iding ��! Fire Grading
Permit Fee $ C
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $ l�a�`�
Plan Review Fee $ C
TITLE
- CITY OF NORTHAMPTON
#. MASSACHUSETTS
OFFICE of th INSPECTOR of BUILDINGS
Page Plot r✓-� > APPLICATION FOR
-,
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. 0
ZONING
_Tl 7 .
I• AT (LOCATION) DISTRICT
LOCATION (NO') (STREET)
OF BETWEEN AND
6
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
—f
1 F� New building Residential Nonresidential
2 Addition(1/ 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 Ll 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) 24 Office, bank, professional
6 Moving (relocation) 16 � Carport
17 [::] Other — Specify 25 n Public utility
7F-1 Foundation only 26 School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8 D Private (individual, corporation, 28 n Tanks, towers
nonprofit institution, etc.) 29 Other — Speci/y
90 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 usel�f existing building is being changed, enter proposed use.
in the above cost i ' ' h 16t I—(TIJA
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 n 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
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 E] Gas Will there be central air 52. Outdoors........................
conditioning?
36 � Oil L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 n Yes 45 i_, No 53. Number of bedrooms..............
38 Coal
39 Other — Specify Will there be an elevators Full.......... I)
— 54. Number of
46 1 Yes 47 Lj No bathrooms
Partial.......
DEPT. OF BUILDING INSPECTIONS BUILDING z° /'?,
! 212 Main Street Oa ll
Northampton, MA 01060 PERMIT <a
28 - 33-28 VALIDATION
DATE Feb. 13, 19 89 PERMIT NO. 86
APPLICANT Michael Mactavish _ ADDRESS 65 Prospect St. , Hatfield 040126
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO Alterat inn NUMBER OF
(__I STORY one Family DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
�I�y�\, ZONING URA
AT (LOCATION) �� �1�7"-`-d ane 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
�F- (TYPE)
REMARKS: pgrmit yO f1n1Sh off rholl fnr carnnd flnnr of Pxi �t.ing Single family dwelling
2 bedrooms and 1 full bath
AREA OR 798 sq. ft. ESTIMATED COST ,� 13,449.00 FEEMIT s 159.60
VOLUME
(CUBIC/SQUARE FEET) .c
OWNER Jodie Shapiro & Joanne Gold
ADDRESS
Gregory Lane, Florence aUIL
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY QP