17C-071 (5) I — —M 1 0 1 .=
Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
IX. SITE OR PLOT PLAN For Applicant Use
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NOTES and Data — (For department use)
l
t —
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
1. /
Owner or �/�^� �I lti� 91 �� J,F S �'i.I'T jT �to.� F/✓�'F� 14, �/6
Lessee
2. L�r �j�j N ! ! . i Builder's
Contractor
License No.
>-pw_j�J— `
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
S
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Pion Review Date Plans B Date Plans
Fee Started Y Approved BY Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or A rovaI Check Date Date
pp 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
Permit issued 19 Use Group
Building ' Fire Grading
Permit Fee $ ,� R��
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $ �. n•*_�
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�. ';� MASSACHUSETTS
$ f OFFICE of the INSPECTOR of BUILDINGS
I Page Plot APPLICATION FOR
,�T
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX.
/ (/'� y/ /,r-' ZONING 1
(• AT (LOCATION) `—"� 'e S/ / DISTRICT 1
LOCATION (NO.) (STREET)
OF BETWEEN (CROSS STREET)
BUILDING CROSS STREET) AND
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D X
M
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
--I
1 ❑ New building Residential Nonresidential
2❑ Addition(If residential, enter number 12 One family 18 ❑ Amusement, recreational
of neeu housing units added, if any, 13 ❑ Two or more family — Enter 19 ❑� Church, other religious
in Part D, 13)
number of unit's— — — — —� QO�� Industrial
3 Alteration (See 2 above) 14 Transient hotel, motel,
I� ❑ 21 �� Parking garage
4 u Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (If multifamily residential,
of units ——————— — —)' 22 �� Service station, repair garage
enter number of units in building in 15 L❑ Garage 23 ❑� Hospital, institutional
Part D, 13) 16 Carport 24 Office, bank, professional
6 ❑ Moving (relocation) 25 ❑ Public utility
17 ❑ Other — Specify
7 ❑ Foundation only 26 L❑ School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
28 L❑ Tanks, towers
8 � Private (individual, corporation,
nonprofit institution, etc.) 29 Other — Specify
9 D Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food
sy:a— processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement................
—eeo" 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 OT1
a. Electrical..................... l,Utr;
b. Plumbing ...................... 1
d
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
48. Number of stories................
30❑ Masonry (wall bearing) 40 Public or private company
41 Private (septic tank, etc.)
31 49. Total square feet of floor area,Wood frame P all floors, based on exterior
32 ❑ Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
50. Total land area, sq. ft. ...........
34 Other — Specify 42 Public or private company
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 Gas Will there be central air 52. Outdoors........................
36 Oil conditioning° y L. RESIDENTIAL BUILDINGS ONLY
37 E j Electricity 44 Yes 45;✓3 No 53. Number of bedrooms.............
38 ❑ Coal
3971 Other — .Specify Will there be an elevators Full..........
54. Number of
bathrooms
46 1 I Yes 47 'Y_ No Partial........
DE&f..OF%,BUILDING INSPECTIONS BUILDING �O
212 Main Street OO<
Northampton, MA 01060 PERMIT
17C - 71 VALIDATION
APPLICANT Gary Worden DATE .31IfP �)9 e ut MIT F lO o rCp� `g-
1
ADDRESS
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO Alteration (_) STORY One Family DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 91 Chestnut St. ZONING
DISTRIC
(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: Permit to make 3 bedorooms into 2 bedrooms
AREA VOLUME 5
E ESTIMATED COST � ,000•OO PERMIT EE 20'00
(CUBIC/SQUARE FEET)
OWNER Same aS Applicant
BUILDI1W@10,
ADDRESS Same as Applicant' s BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY p0" P