17A-043 (4) ZONING
DISTRICT
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)
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OP-
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IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
µ
J 417
1. ,lt�' /N
Owner or � /v f
Lessee
Builder's
2. I� �/�/ 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 pplicont Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
9 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date D
Permit or Approval Check Obtained Number By Permit or Approval Check Obtta t ed 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 r� t 19 G�
Building �) Fire Grading
Permit Fee « 1 V
—� — Live Loading
Certificate of Occupancy $ Occupancy Load
Approve by:
Drain Tile $
Plan Review Fee $
TITLE
}
CITY OF NORTHAMPTON
�. .� MASSACHUSETTS
OFFICE of the INSPECTOR of' ILDINGS
Page _ Plots APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, Ill, IV, and IX. O
ZONING
1>
I• AT (LOCATION) �!-1, �r/1 DISTRICT tf
LOCATION (N0.) (STREET)
OF BETWEEN AND
BUILDING CROSS STREET) CROSS STREET)
LOT
SUBDIVISION LOT" _BLOCK SIZE
H
11. 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 0 New building Residential Nonresidential
20 Addition(if residential, enter number 12 ne family 18 Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 D Two or more family — Enter 19 �] Church, other religious
number of units— — — — —� 20�] Industrial
3 Alteration (.See 2 above)
140 Transient hotel, motel, 21 Parking garage
4 Repair, replacement or dormitory 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
P rt D, 13)
16 Carport 24�� Office, bank, professional
6 Moving (relocation)
17 �] Other — Specify_ 25 n Public utility
7 n Foundation only
26 School, library, other educational
B. OWNERSHIP 27 L] Stores, mercantile
8 I1Xrrivate (individual, corporation, 28 �] Tanks, towers
nonprofit institution, etc.) 29 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
L1 processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,,,,,,,,,,,,,, school, secondary schoo , college, parochial school, parking garage for,
department store, rental 3ffice 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 C] Mo onry (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 D Public or private company 50. Total land ores, 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 C] Gas Will there be central air 52. Outdoors........................
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 CJ Electricity 44 [ es� Y 45 N. 53. Number of bedrooms..............
38 ❑ Coal
39 Other — Specify Will there be an elevators Full..........
_ 54. Number of
46 1 Yes 47 '`] Nc, bathrooms
Partial........
City of Northampton REQUIRED INSPECTIONS
$ 1 . Footings and Walls
.. BUILDING DEPARTMENT 2 - Placetural Components in
3 . Complete Building
No. 486 Office of the Building Inspector
Date AUGUST 3. 1990_
� TTYF "IXTI'l ]DIU _'D _N4]Fr1P
" U XILA Y-LI I X.T 1 AVIVA-L it
THIS MAY CERTIFY THAT HATFIELD TRADESMEN Insp. on Site — Foundations
has permission to INSTALLNEW DOOR OPENINGS Insp. of Plumbing — Rough
situated on 188 BRIDGE ROAD Insp. of Plumbing — Finish
provided that the person accepting this permit shall in every re- Insp. of Wiring — Rough
spect conform to the terms of the application on file in this office,
and to the provisions of the Statutes and the Ordinances relating Insp. of Wiring — Finish
to the Construction, Maintenance and Inspection of Buildings in Insp. of Health (Septic Tanks)
the City of Northampton. Any violation of any of the terms above
noted is an immediate revocation of this permit. Expires six Building Insp. — Rough
months from date. Building Insp. — Finish
` Note: A certificate of occupancy will be issued by this office upon
return of this card signed by the Plumbing,Wiring and Building Smoke Detectors (Fire Dept.)
Inspectors. Gas Inspection
THIS CARD MUST BE DISPLAYED IN A CONSPICUqrS C EMISES
Certificate of Occupancy
Buil nspector
. PRINT SM P