17A-302 (6) Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
REAR YARD
IX. SITE OR PLOT PLAN For Applicant Use
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or /��CE/N / �it�C�� ��• A x �.���� !/� �/ 1f't" Q/n�G ✓���
Lessee
Builder's
2. Q ! = �/✓C ��Ga/aC7 ��fG� _ f0������ 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 oppli ation as his au ed agent and we agree to conform to all applicable laws of this jurisdiction.
Sign ure of op scant Address �' Application date
:,A6
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date P y Ions B Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Permit or Approval Check Obtta ned Number By Permit or Approval Chec Obtta tned 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 �0 FOR DEPARTMENT USE ONLY
Permit number SLY
Building• Use Group
Permit issued -1L?I! �yU - 12T_ 192
Building Fire Grading
Permit Fee $ '(vJ ' ( ) Live Loading
Certificate of Occupancy $ Occupancy Load
App by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
10 MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Pagel Plot 7 APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant t//��o complete all items in sections: 1, 11, 111, IV, and IX. (/ O
ZONING
I• AT (LOCATION) ////c 4, 6X,, -r7_ Cam— DISTRICT OW
LOCATION (N0.) (STREET)
OF BETWEEN ' -?�el C. iC /L e"V AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
V1
11. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
rn
1 New building Residential Nonresidential
2 Addition(If residential, enter number
12 F7 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
3 Alteration (See 2 above)
number of units- - - - -� 20❑ Industrial
❑
14 ❑ Transient hotel, motel, 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory - Enter number
5 ❑ Wrecking (If multifamily residential, of units ------- - -i 22 ❑ Service station, repair garage
enter number of units in building in 15 ❑ Garage 23❑ Hospital, institutional
Part D, 13) ❑
16 Carport 24❑ Office, bank, professional
6 ❑ Moving (relocation) /
17 Other - peci/y 25❑ Public utility
7 ❑ Foundation only
26❑ School, library, other educational
B. OWNERS ��� 27❑ Stores, mercantile
8 Private (individual, corporation, 28❑ Tanks, towers
nonprofit institution, etc.) �'2 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
7f- 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 $ L747 �¢
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. TY�Pu WAGE DISPOSAL J. DIMENSIONS J
30❑Masonry (wall bearing) 40 or priv ate company Number of stories...............
31 ❑ Wood me 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�TER SUPPLY
34 ❑ Other - Specify 42 ublic 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 1. TYPE OF MECHANICAL 51. Enclosed .......................
35 ❑ Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 i N o
❑ Y es 45 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other - Specify Will there be an elevator? Full..........
54. Number of
46 ❑ Yes 47 ❑ No bathrooms Partial........
IDepartnent of Building Inspections
212 Main Street
Northampton, Mass. 01060 BUILDING z o° �a
PERMIT
7 IL
17A - 302 VALIDATION
�p� q Sept. 7, , 884— P M,T No. 405
M='I Mel&i—e '1rl1rneZDRESS r1� H113-cr st drive
APPLICANT
(N0.) (STREET) (CONTR'S LICENSE)
Addition NUMBER OF
PERMIT TO (_) STORY Swimming Pool DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) 115 Hillcrest Drive DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Pool
)DOOjDOWIS TO BE 20 FT. WIDE BY 24 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
Tip (TYPE)
REMARKS. permit for the installAtion�i.•:of an in ground pool
AREA OR ESTIMATED COST .� 3,500.00 FEEMIT $ 10.00
VOLUME rl,(CUBIC/SQUARE FEET)OWNER Melodie Turner BU 1 L G
ADDRESS 115 Hillcrest Drive BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY - PINK - ASSESSORS COPY