17C-100 (3) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
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BOCA FORM APEBP — 669 01969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or c 1, / C , C //� J Vi'} �' it h-t
Lessee } '
1 License No. r 177
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.
Si lure
7ppI.7 t; Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re wired Check Plan Review Date Plans B Date Plans B Notes
9 Fee Started y Approved y
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL Is
OTHER
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Doe 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 i Use Group
Permit issuedr119
Building T Fire Grading
Permit Fee �����C� Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee f
TITLE
NOTES and Data — (For department use)
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 PLAN EXAMINATION AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. C
G _ �)•'� � t C y �Z! ZONING
AT (LOCATION) 11A
DISTRIC6
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
H
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
m
--I
1 ❑ New building Residential Nonresidential
2 Addition(I residential, enter number
J 12❑ One family 18 D Amusement, recreational
of new housing units added, if any, 13® Two or more fami ly - Enter 19 E] Church, other religious
i Part D, 13) number of units- - - - � _ 20 ❑ Industrial
3 All teration (See 2 above) 14 l
l
h
Transient hotel, mote ,
❑ 21 ❑ Parking garage
4 Repair, replacement or dormitory - Enter number
• _------ - 22 � Service station, repair garage
5 ❑ Wrecking (If multifamily residential, of units -�
enter number of units in building in 15 F-1 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 ❑ 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................ 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 $ -)Lt
` .( G
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 Number of stories...............
31 FS Wood frame 41 Private (septic tank, etc.) 49• Total square Feet floor area,
all floors, based on exterior
32 ❑ Structural steel dimensions ..................... �)
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY /
34 ❑ Other - Specify 42X Public or private company 50. Total land area, sq. ft. ........... 0'et(�
43 ❑ Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL /
❑ 52. Outdoors........................
35 Gas Will there be central air
36 Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 ❑ Yes 45 P No 53. Number of bedrooms........
38 ❑ Coal l
39 ❑ Other- Specify Will there be an elevator? 54. Number of Full..........
46 ❑ Yes 47 NNo bathrooms
Partial....... 0
I ,
hereby certify that the-proposetF'uvork is authorized by the owner of'record9
and I have been authorized by the owner to make this application as his
authorized agent. a ._
z :
SIGNATURE'6E AGENT -
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
F _ _
DEPT. FILE COPY
DEPARTMENT OF BUILDING INSPECTIONS z°-
M WN STREET BUILDING
NORTHAMPTON, MA. 01060 PERMIT
VALIDATION
170 - 100 Code #79
DATE September 27,E 197_ PERMIT-NO. 479
APPLICANT Jill Shaw ADDRESS Sti]Assn Aye;
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO C.hiMna & f.AV (-) STORY Free—at f r NUMBER OF
�(i 1� @ �,r�,�(,+� DWELLING UNITS
(TYPE OF
IMPROVEMENT) N t (PROPOS USE)
AT (LOCATION) 35 Stilson Ave;( ZONING URB
DISTRICT
(NO.) (STREET)
a, BETWEEN AND
b (CROSS STREET) (CROSS STREET)
a_
IL LOT
m SUBDIVISION LOT BLOCK SIZE
U
O BUILDING IS TO BE FT, WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
f
� (TYPE) -
REMARKS: ___ Install metal bestos chimney & free-standing fireplace
N o ate @ Lr e l:ai dG' J"? I?
�f /D. ILI._ I
AREA OR PERMIT
VOLUME ESTIMATED COST $ 300.400 FEE $ 1O:`OO
,t (CUBIC/SQUARE DARE FEET)
OWNER Riehard Devine
DI EP .
ADDRESS 6 Arlington St. , Easthampton, Ma. 01027 BU 8Y AJ
(Affidavit on reverse side of application to be completed by out orized agent of owner)