17A-304 (2) ZONING •
DISTRICT
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NOTES and Data — (For department use)
3
IV, IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, ami State ZIP code Tel. No.
�i rJ
Owner or
Lessee
c Builder's
2' •�• �/ ��� . eO ..S� M Q 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 f applicant Address Application date
ol 00
00 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
9 Fee Started y Approved y
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 FOR DEPARTMENT USE ONLY
Permit number
Building. Use Group
Permit issued l.�` %�. tT 19
Building Fire Grading
Permit Fee Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $ �, ,;
Plan Review Fee $_ t >
TITLE
CITY OF NORTHAMPTON
�•�� MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDING
Page /� 0�Plot
��r g —+ APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
I• AT (LOCATION) W� /—'(NO.) pr1 fomel1. , (–(!g � STR CT
LOCATION (NO.) (STREETI I
OF BETWEEN AND
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
1 New building Reside tial Nonresidential
2 Addition(lf 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 ❑ Repair, replacement or dormitory – Enter number
5 ❑ Wrecking (1l multifamily residential, of units ––––––– – -- 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) P
17 ❑ Other – Speci/y 25❑ Public utility
7 ❑ Foundation only 26❑ School, library, other educational
B. OWNERSHIP 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,
IF 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 1$qNCM
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 Z
30 L:1 Masonry (wall bearing) 40 Public or private company
48. Number of stories................
31 KWood,fra me 41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior 7�/�
32 trucural steel dimensions Zvc�-/
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
Z'
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed .......................
35 ❑ Gas Will there be central air 52. Outdoors........................
36 Oil conditioning?
- L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 ❑ Yes 45'5<No 53. Number of bedrooms..............
38 ❑ Coal
39 Other – Specify Will there be an elevator's
Full..........
54. Number of
46 ❑ Yes 471,5�No bathrooms Partial........
DEPT. OF BUILbING INSPECTIONS BUILDING �°
212 Main Street o
I IL
Northampton, MA 01060 PERMIT
17A - 304 VALIDATION
DATE October 19, 19 84 PERMIT NO. y 590
P.O.APPLICANT Waren Hall ADDRESS r Box 511, Amherst, Alass. 022384
IND.) (STREET) (CONTR'S LICENSE)
OF
Foundation Only One Family Home DWELLR
PERMIT TO STORY
-DWELLING NUMBER(_)
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION)
Lot #52 Hillcresdt Drive, Florence DIOSTR CT
(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
(TYPE)
REMARKS, ermit for the construction of a foundation only
AREA OR 2200 S ft. 4,000.00 PERMIT $ 16.00
VOLUME q. ESTIMATED COST
(CUBIC/SQUARE FEET)
in Z�L_T_z OWNER Ski & Karen Lentner
Park t• Easthampton BUILDING D DJ
ADDRESS
WHITE - FILE COPY . GREEN - FIELD COPY CANARY - APPLICANT COPY - PINK - AS SSORS COPY p'INT SIIp