17C-107 (12) Vill. ZONING PLAN EXAMINERS NOTES
FRONT
SIDE YARD SIDE YARD
REAR YARD
IX. SITE OR PLOT PLAN For Applicant Use
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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 I
Builder's �� ��
License No.
2.
Contractor VC i O 034- M'1\ "4 IZ
3. t
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.
Signs of applicant Address Application date
Cr t N, vtn�►+� s+'
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plan Review Dote Plans B Date Plans By Notes
Plans Review Required Check Fee Started y Approved
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 19
Fire Grading
Building
Permit Fee Live Loading
Occupancy Load
Certificate of Occupancy $
Appro by:
Drain Tile $ I L_�
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
LT Page Plot
APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. p
• AT (LOCATION)— td 6 1r DZONING
ISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN 4-eS TV AND LAA—PLi
�
BUILDING (CROSS STREET) (CROSS STREET)
SUBDIVISION LOT BLOCK LOT SIZE
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
1 New building Residential Nonresidential
2 Addition(If residential, enter number 12 One family 18 Amusement, recreational
new housing units added, if any,
in Part D, 13) 13 Two or more family — Enter 19 Church, other religious
Alteration (See 2 above)
number of units— — — — .- 20 Industrial
3
14 Transient hotel, motel,
Repair, replacement, 21 Parking garage
or dormitory — Enter number r
5 ❑ Wrecking (1l multifamily residential, of units ——————— — -- 22 1� Service station, repair garage
enter number of units in building in 15 C� Garage 23
Part D, 13) Hospital, institutional
6 Moving (relocation) 16 ❑ Carport 24 L Office, bank, professional
7 Foundation only 17 Other — Specify 25 E] Public utility
26 School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 Private (individual, corporation, 28 Tanks, towers
nonprofit institution, etc.) 29 J Other — Specify
9 L 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,,,,,,,,,,,,,,,, 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 cosh a. Electrical.......................
b. Plumbing ......................
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
yw r, r
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. TY���P///E OF SEWAGE DISPOSAL J. DIMENSIONS
30❑ Masonry (wall bearing) 40 Public or private company 48. Number of stories................
31 Wood frame 49. Total square feet of floor area,
41 _ Private (septic tank, etc.) �
32 Structural steel i
all floors, based on exterior 9k
I&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 G as Will there be central air 52. Outdoors........................ ,
36 Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 F_ 1 Electricity 44 �� Yes 45�, No
38 Coal
53. Number of bedrooms..............
��
39 �� Other — Spedjy Wi II there be an elevators 54. N Full..........
umber of
46 ) Yes 47 No bathrooms
Partial.......
�DEPT`OF BUILDING INSPECTIONS BUILDING ZD
+ 212 Main Street 04 ;yq
Northampton, MA 01060 PERMIT <a
17C - 107 VALIDATION
DATE ju 6, R J �E'teT NR 034783
APPLICANT Bob Walker ADDRESS (� ery 1 ce entter Rd. �83
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO
Alteration/Addition( STORY One Family NUMBER OF
UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 81 High St. OIISTR 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. permit for the alteration/addition of a bedroom dormer 9' X 16'
VOLUME 144 $g. f t. ESTIMATED COST .$ 7,000•00 FEEMIT $ 24.0
(CUBIC/SQUARE FEET)
OWNER Pall & Mary Weinb e ra BUILD
ADDRESS 81 HiQh Street,--Florence ___ BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY p0-111,