17C-058 (5) ZONING • / ►
DISTRICT
USE
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SIDE YARD SIIE YARD
Ix. SITE s
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OR PLOT PLAN For Applicant
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NOTES and Data — (For department use)
1�� CD.��a-t�t � � -t-.�$�ti� _
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IV, IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, trret, city, and State ZIP code Tel. No.
Owner or /a 6V
Lessee
Builder's
2. 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 of applicant Address Application date
Z-2 7- ,272
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 Is
OTHER I Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Permit or Approval Check Obtained Number By Permit or Approval Check ObttaiTned 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 19
Building i Fire Grading
Permit Fee
Live Loading
Certificate of Occupancy $ Occupancy Load lift
Approved
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
g. MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
ur
Page L Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, Ill, IV, and IX. 0
ZONING
I• AT (LOCATION) 3 t' DISTRIC
LOCATION (N .) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) ICROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
(A
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
) New building 9 Re i entiol 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 ❑ 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 ——————— — --). 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 — Specify 25 L Public utility
7 ❑ Foundation only
26 ❑� School, library, other educational
B. OWNERSHIP 27 L� 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,
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 r
a. Electrical..................... ' c
i
b. Plumbing .....................
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT 1$ /
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 private company 48• Number of stories................
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 gillth be central air 52. Outdoors........................
:, COnaTil.p n4r1!Q�
36 ❑ Oil L. RESIDENTIAL BUILDINGS ONLY
37 Electricity. "#�„ d4'• r'1ies, - 45 � ! No 53. Number of bedrooms..............
38 ❑ Coal � '
i
39 ❑ Other — Specify Willthere be an elevatoro Full..........
_ 54. Number of
46 Yes 47 ' No bathrooms
Partial.......
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DEPT. OF BUILDING INSPECTIONS BUILDING IDZX�)
212 Main Street 0
Northampton, MA 01060 PERMIT
17C - 58 VALIDATION
DATE SP�nt.. _�(7� )� e$ nUfPSI�IT NT 621 lorence Owner
APPLICANT Edward Hurlburt ADDRESS J� r
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO New Building (_) STORY Storage Shed DWELLRING OF
UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
1 ZONING
90 Chestnut Street UkA
AT (LOCATION) DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE 8 FT. WIDE BY 10 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS, permit for the construction of a storage shed
AREA OR VOLUME 80 $Q. f t. ESTIMATED COST $ 695.00 PERMIT $ 10.00
(CUBIC/SQUARE FEET)
OWNER Same as Applicant BU
ADDRESS Same as Apgl icant I s BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY ■ PINK/ASSE S SORS COPY P'INTIP