17C-053 (5) ZONING •
DISTRICT
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SIDE YARD 1 1
REAR YARD
IX. SITE OR PLOT PLAN For
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NOTES and Data — (For department use)
MW
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
x(j
Owner or • � �
Lessee
Bui 1. �� 2 Licenser�N0.
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.
Sign ur of app 'c nt Address Application date
1
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approva I Check Date Number B Permit or Approval I Check Date Number
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 number
Building r( Use Group
Permit issued \�T- 19
Building 7�7 Fire Grading
Permit Fee $ ��,1 Live Loading
Certificate of Occupancy $ Occupancy Load
$ Approved by:
Drain Tile
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
$ OFFICE of INSPECTOR of BUILDINGS
wT Page Plot__53 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
I• AT (LOCATION) / r DISTRICT
LOCATION (NO.) (STRE T)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D ;a
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
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 F—] Industrial
3-W Transient hotel, motel,Alteration (See 2 above) 14
❑ 21 C� Parking garage
4 Repair, replacement or dormitory — Enter number
of units ——————— — --f 22 L� Service station, repair garage
5 ❑ Wrecking (1/multi/amity residential, "
enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional
Part D, 13) 16 ❑ Carport 24 ❑ Office, bank, professional
6 ❑ Moving (relocation) 25 ❑ Public utility
17❑ Other — SpeciJy
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,,,,,,,•,.••.... 1,616)0 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 $ )
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 company 48• Number of stories..............
31 W Wood frame 41 ❑ Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior l�
32 Structural steel dimensions ..................... /
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other — Specify 422 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 kas Will there be central air 52. Outdoors........................
36' il conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 Cj Electricity 44 ❑ Yes 45 No 53. Number of bedrooms.............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevators Full..........
_ 54. Number of
46 Yes 47 No bathrooms
Partial......
now
� v
a DEPT. OF BUILDING INSPECTIONS BUILDING ZO
! 212 Main Street O< ~4
1
Northampton, MA 01060 PERMIT
17C - 53 VALIDATION
DATE November 6, t9 86 PERMIT NO. 65'53
APPLICANT ,]pe D44 i4A ADDRESS {(��{�; f2
LICEN
IN .1 E ICONTR•S SEI
One Fami 1 NUMBER of
PERMIT TO (,1 STORY y DWELLING UNITS
( Y 1 0 NT) NO. (PROPOSED USE)
28 Strawberry Hill ZONING CT URA
AT (LOCATION)
(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:
taking down some walls and adding windows. Extra space will be used for living room +
dining room addition t!
AREA OR2,400. sQ• ft. ESTIMATED COST $ 10,000•0O FEEMIT $ 40.0
VOLUME
{CUBIC/SQUARE FEET)
OWNER Jack & Helen Simpkin
BUILD
ADDRESS 28 Strawberry Hill BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY I®RIP