17C-011 (5) ZONING •
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD_
NOTES
IX. SITE OR PLOT
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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
Lessee
Builder's /rf
1, 6-- License No. VV q71
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
%611 ' r C'o
U 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 Is
OTHER Is
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 I
Bui(ding. 1,
Use Group
Permit issued _ 0 19&
Building ` Fire Grading
Permit Fee $ Lr `J Live Loading
Certificate of Occupancy $ Occupant d
PPr ve by: 7 d
Drain Tile
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�•�� MASSACHUSETTS
t
$ OFFICE of the INSPECTOR of BUILDINGS
,uT Page,/ 7 — Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O
Q
I• AT (LOCATION) I'� °J \ 1� _ ( ZONING DISTRIC�C
LOCATION (N0.) (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 —f
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
M
1 ❑ New building Residential Nonresidential
2 Addition(If residential, enter number 12 ❑ One family 18 ❑ Amusement, recreational
cif net, 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 (if multifamily residential, of units ——————— — —3. 22 ❑ Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional
Part D, 13) 16 ❑ Car ort 24❑ Office, bank, professional
6 ❑ Moving (relocation) p
17 Other — Specify /'� // 25 n Public utility
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP JAW) 27 ❑ Stores, mercantile
8 Private (individual, corporation, —__ "may 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
JJ r processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement••,,,•,•••,,•,,, / r' C G ° 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..................... c C c,'C`
b. Plumbing ..................... + tiC
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 ® 48. Number of stories................Public or private company
31 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
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
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
l37 Electricity 44 ] Yes 45 '_2C No 53. Number of bedrooms..............
38 Coal
39 Other — Spccijy Will there be an elevators Full..........
54. Number of
46 Yes 47 I� No bathrooms
Partial.......
Department of Building Inspections
212 Main Street'' BUILDING Z°
Northampton, Mass. 01060 PERMIT <
IL
17C - 11 VALIDATION
DATE August 31, 19 83 PERMIT NO. 437
APPLICANT Louis Montgomery ADDRESS 116 Straw Avenue 013471
(NO.) (STREET) (CONTR'S LICENSE)
Addition NUMBER OF
- PERMIT TO (_1 STORY Small G1ork Shoff DWELLING UNITS -
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) 2&4 Lake Street, Florence DISTRICT URB
(N0.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
C511D
BUILDING IS TO BE 12 FT. WIDE BY O FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: permit to build a small private work shop
AREA OR $ 10-00
VOLUME 660 sD ft ESTIMATED COST $ 2.500_00 FEEMIT
(CUBIC/SQUARE FEET)
4
OWNER Louis Montgomery
BUIL G
ADDRESS 116 Straw Avpmiu BY
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