12C-091 (4) ZONING •
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
IX. SITE r,
OR PLOT
• •. rr '.��. � a \ar • :.�e�s:nN.�i:oun/NOa
�� `-:�ii'" s\: =�ir:�i$yur •■.Nr• iNUn■aur•
a w • ii rtlan it ■r!.•iN/N■nN■■•■■■1p
gone• � Ni1 1� e.es ns• eaar Nr NYSr\Nn/
• � t ■ Yir� 1�1�I••■��ta •\■�I�• aarq�:Ni■■nn:•rnir■::iaN•N•a■/
■ • r •• • • :$,�•■.�f�1tt1/aa1t�i11 ■Rir�YRNir••• iH�::: �a�t�•::M::::::::::::::
1 lMi0. ■0s••::er•211 !1•a•■•N :I:::::�f/H■Nr::
ini ■■ i• N■NaN s:\•N•Nn:
*ifi ••.•• utlNa. rna \itr• •N!/1N■rnnr
+/ • \■ •• i rY`(:.ygra w •r•R a N ■��Nwiar ,{11■w.��•■•`.• 1a .y�•p�Yi}� ..• H: ::i :::::�� : ::: g1BlU t�rN■:
N _ qN /�u.i■ \N � :••!RM•I.N: �n\NN_�ra••ii•NY:NNNNN::NraNnia•■!r
I.H. i i\■ ■r s a irw aY rr i+■� • ii••■ sH•N/warwsN■NNnoN■N N•N•
`�•�' .� r{. �� �Ni • • •-t� a .•eeIn.: , a\N■.NN•t.\Nr•=•aNSis■
ie:! . ■ N iR ; ■ a it •iii••a Rar r••NYNiu N•ur NiN ■
• sni f NN •-I�rn • n ■ N�;� ,�• S • � ■n Y now • sNni■e.arN an as annssnNfnaN
me
• :e r r :� �i't:n.I ft, r r ��� �-i: i '','.i:=$rl�:sa assurronaooruauitra
e : s Nas sr • • ii°.. sr • ualia\uro■ al nNnNN■uN
`s i�: N: s N sn �iw o ■aN:aa wa• i N o ■ nur.ruwnNRU Uwrnifaann
wl is .si 'w to Nras•. t • au.. R•f.■■Nr•.irnn•. n■rafNUR
1 • u: nn n:: : e: • �r _ +� il�iq•+�lltiiil�i�i•n•N•I�Nnsnnu=nn■!uN!
• r �I�Z�+� a i�s ■ �1 •. �.. ■• = NrnN NNa1•■Nr•rua■o::*
r: •i N s ■NN ii • : iu:• • nNNNNNr nNUauanoon
:: •N N it • iN Nw.■ ■ sus • ■iN r •r./n riHN■i ■■1sN..■.n■N■•
ael •e rn cure r�l •N:�i\:+•i�l�i•� :�r+s••11'i�i ti�ii�• • i•r■� �! •aN■I�anrasuN�iaa=i::ii::ai:
i • �•:�� R : ■ i. 1N'i\• i• n �• '�iHiii�i I ��.�,�, :::a::::::::::• R:■i/I•NNU■
r 1 R u e � u a • wNRa ■ • rns• unu
�� • • � Nlra•��i7i++i'siN� n�f •�i � awn �S,e���� � RN:■N:�iiiii: • �ni a�r��i�i�r��:i r�s:r:�Z■uuoNOU::
a$• n pp ;;jj�pr,rr(1�ss�:�r: 1111:� aR �I n •n ai.i.....■■rni.
i • t1.a i1t•• i• i __Ii w • : ee ■ • ■N•:ii.■■■tN1Nn•usttln•
11 liNNY•Iii. ///U�MM ■■■■■ i•HNaa �,�4�1ir � �q�/�RaR�N ���:N.RR:ROOnuuu
u • • ■ui 6801108:12:61:1,0010:ouu
1■ • • . N • • • s r ■n. .■ uos/nur
i iNN•N men
n ��1 !;� NN�����I��ti \•RN••r•■r•ria■•. OlBO■Nr■rNN•
1 • i a rr n• e • iN a• R7Y N nNn ■ season., on r■NtN■nar■
Iss:rw •�•• \ �� t,�jj�=•��I i .• • irli/si '�■ra•ia• � y1�• js�Y•i�iN ■a�non■••q•1�1:: :[:::::::::::
• :� .•e:rrliw.a:.nf■ :::H'IINM r •■sll•i .i/•• ■Htai�rlNia::•+N::I�IIrN NNRN■n\Nn•
ii•wsia ■■ • .1••a •N•nu suYYn •■•• NatS■Nwr•llr • su•/i1 • •Y.parp�r••N !N rNi•n■■ uN\NO■r •INC,
+•� i N \i •.1r r l.pN�laNN\.srt/i %r:/�MI:i■r•1.iY: _ • I\`i 'R`� �11ii iNi \i �% sam r�•::ii ■SIN:
•iq ••■ ■ MlNNa •a,II RiaN •I\Ntii.•• •fi. R::::Mt r1:i:3 :: i' :`• i si aivan
Nr• N/ N to • • . ■ • .nuu • root = a Y. N Nn N ess ifa•• is ��/iNii�R•1 ■:.'.aar ::�ai „■ ti■i NNO•Z s�� _1 ••�•.�n INr ...r••�1� � /'N■1 i11M���I+NNN aiRSsir:ii:Yii.....s:n:::.
+� a as f • • n uNnaN•.... I /r ■ ■ N u •• n
Mr • n=•isMl� eeeeeM s •6MMMi eerNej Ii t••�1 M■1�Nr ur r n ■ nN rn NinnuuNNNn■
g� •q. �:•• :'•�ii ■ i,a:i:r« ! :M : ry �•i•�i ' �i•: a '1N�i•�onn : ,�i: N�..suNnnutNr
I p •. ::i :siSMN :M•::: \ ■•1/• al /Igfii• � N Y•fa■tail.\\•
• r• Na R■. a• aY • n N■NNasso esUflr
■ s N• i as •■ !aN isN is•sN:N ■ • • i • 1iiNpq • unpnYN•N •urt
i alm Y■ iM tr reMetMr.see ■ : : r •rM a:a•iRl•i:i seal :eeH::ire::%
f I � �� •• • 1t n • •t I ■aNn:MAN•
{,'j� ■ N Nar n ■ • •a :::
tap, :i• ii a : • : Ne� ■" 0 um: •
�tp,Silk:�i'rn.iiiai_i:�ii•�ii� i �� ��ii:Ywi.rn��r■■NNaur
+ N+�at 1N frR }�I/r • a r eS. n'es jNsHS::t0i:.
• •_* :� �• �iriiii i .�1i n••s\�e1i�MUSEUM!
silo �Iw �=Mill w �_N■ n:Mrl
• ,+ u N �Ir�i �i•�I�sa=iaii:nil:
•• � +as :i a:: ■ �i:+\+\Riii::a 1{�ri•:nu:nrNY�
+ •. rl • .. • •■ Is r N. r� : ar�a
Ullf
r
race Mi
■ Nu/A \oi
cuOne■ ■a\=1:
e:a se: Wasi:ssrl
anon an I
• a • aN\y�ne�iur••Ynan
n a :e1�iyyr=�C•e�•sL�:,Y:N=!egm errs 1 ::• Nr.: MMiei�0:I
as
I
rt r re�M°ei
n r::1M�ia�
_. .11111
nr
iNHrfl/,N11N/
� O_
NOTES and Data — (For department use)
1
i
t
1
r
t '
yP
t
6i i
a J
i
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Nurohc'r, street, itN, arld Ctatr ZIP code Tel. No.
. ,,�� ��.,.- !o i a L 6C.
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 applicant Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plan Review Date Plans B Date Plans
Plans Review Required Check Fee Started Y Approved BY Notes
BUILDING $
PLUMBING $
MECHANICAL
ELECTRICAL
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obtained Number By Permit or Approval Check Obtained 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 Ft `
Permit number
Building
Permit issued �� 19 .7
Building
Permit Fee $_�O
Certificate of Occupancy S
Approved by:
Drain Tile
Plan Review Fee $_
TITL
ro City of Nort4am ton
� ,� �lrtssizdfusetfs
Offzte of the ltts}1Ertur of 11Ildittg5 APPLICATION FOR
Page ' LAC Plot ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. Z
O
I. 15— /gf,7 (/(7 ZONING
AT (LOCATION) 9!� /IX�LLL DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
M
1 New building Residential Nonresidential
2 ❑ Addition(IJ 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, ❑
4 ❑ Repair, replacement 21 ❑ Parking garage
p p or dormitory — Enter number
5❑ Wrecking (if multifamily residential, of units ------ — — —)� 22 ❑ Service station, repair garage
enter number of units in building in 15_1�1.,Garage 23❑ Hospital, institutional
Part D, 13)
16 F__] Carport 24❑ Office, bank, professional
6❑ Moving (relocation)
17 ❑ Other — Specify 25❑ Public utility
7 ❑ Foundation only 26❑ School, library, other educational
B. OWNERSHIP 27❑ Stores, mercantile
8 lk 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,,,,,,,,,,,,,,,, d® 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 ..................... i,
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. y
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS 0
M
30❑ Masonry (wall bearing) 40 ❑ Public or private company 48• Number of stories................
3V 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
34E:] 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. TYPE OF MECHANICAL 51. Enclosed ....................... r—
O
35 ❑ Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37❑ Electricity 44 es o
❑ Y 45 N 53. Number of bedrooms..............
38 ❑ Cool
39❑ Other — Specify Will there be an elevator? Full..........
54. Number of
46 ❑ Yes 47 !k No bathrooms Partial........
I hereby certify that the proposed work is authorized=`by'the.-own�t of record
and I have been authorized by the owner to make this application as his
authorized agent. a
SIGNATURE OF"'AGENT:
_
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
DEPT. FILE COPY
ZD
-.. D-
BUILDING
City of Northampton PERMIT
VALIDATION
Northampton, Mass. 12C - 91
DATE AuglicA 29, 19 22 PERMIT NO.
�W.--
APPLICANT Ri l I V T+' sill l i van ADDRESS
( OJ ]RiC(STW31e! Plorenee (CONTR'S LICENSE)
NUMBER OF
PERMIT Ti (_) STORY '(amge _ DWELLING UNITS
(TYPE OF IMPR VEME NO. �' (PROPOSED USE)
ZONING p�
AT (LOCATION) 1R T)r
irk jyp DISTRICT
Un4i
A.) (STREET)
0. BETWEEN AND
.o (CROSS STREET) (CROSS STREET)
a
LOT
a- SUBDIVISION LOT BLOCK SIZE
ao
a
O
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
I (TYPE)
O:
0
LL REMARKS:
AREA OR ESTIMATED COST $ 2200.00 FEEMIT $ 10.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER Billy 2+' II I 11Va,n BUIL G T.
ADDRESS BY ��
(Affidavit on reverse side of application to be completed by rigid agent of owner)