17A-099 (3) Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT 4
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 C1969 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
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
V_4 y__
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
q Fee Started y Approved y
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check ObDtaaTned Number By Permit or Approval Check ObEta 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
V11. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building .f� - Use Group
Permit issued 191
Building. r. �� f Fire Grading
Permit Fee . _.,/ '�� Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile
Plan Review Fee /
T LE
NOTES and Data — (For department use)
Z-1
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: I, 11, 111, IV, and IX. O
+ ZONING f
I• AT (LOCATION) �'� '`` `�%'t-�-K �-� DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
f/1
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
1 FP New building Re idential Nonresidential
2 Addition(If residential, enter number 12One 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 l
t
l
t
h
i
Transent hotel, motel,❑ 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
__ 22 ❑ Service station, repair garage
5 F-1 Wrecking (if multifamily residential, of units — — --)o
enter number of units in building in 15 Garage G(R CGt� 23 ❑ Hospital, institutional
Part D, 13) ❑
16 Carport 24❑ Office, bank, professional
6 ❑ Moving (relocation) 2 ❑
17 ❑ Other — SpeciJy 5 Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8 Private (individual, corporation, 28 ❑ Tanks, towers
onprofit 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,,,,,,,,,,,,,,,, s 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 is
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 ❑ Wood frame 41 ❑ Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based n 4 te�i r��
32 F-1 Structural steel dimensions .., ,y /-%I
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 F-1 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 Will there be central air 52. Outdoors........................
36❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37❑ Electricity 44❑ Yes 45 ❑ No 53. Number of bedrooms..............
38 ❑ Coal
39❑ Other — Specify Will there be an elevator? 54. Number of Full..........
46 El Yes 47 ❑ No bathrooms
Partial.......
h
a c,
NEW
V � }
M
v a g .
Fr}
�a
a�
.............
a
i- —Spool
hereby certify that the proposed, work is authorized by the
owner of*record
and I have been authorized by the owner to make this application as his
authorized agent. — f
SIGNATURE OF AGENT - -
ADDRESS
(NUMBER) (STREET)
(CITY)..
APPROVED BY TITLE
DATE lg
e _� C C7 f'y:` _.
IEPAR`ii NT OF BUILDING INSPECTIONS Z o DEPT. FILE COPY
NOR HAMPTON . 01060
BUILDING
PERMIT VALIDATION
17A - 99 q
DATE April 24, ig_7_ PERMIT NO. 144
APPLICANT Leroy J. Holman - ADDRESS 27 Grandview
(N0.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO NP_jej &'97'�ApA_ (_'�) STORY 2 Gar garage DWELLING UNITS 1
(TYPE OF IM OV EMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) 27 Grandview DISTRICT THU
(NO.) (STREET)
a BETWEEN AND
Q (CROSS STREET) (CROSS STREET)
LOT
(L SUBDIVISION LOT BLOCK SIZE
p BUILDING IS TO BE 22 FT. WIDE BY 24 24 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
U. REMARKS: Constructs 2 car detached garage
AREA
OLUME ESTIMATED COST $ 00 00 PERMIT $ 10.00
(CUBIC/SQUARE FEET)
OWNER Leroy J• Holman '
ADDRESS 27 Grandview Street, N'ton, BUILD G P
(Affidavit on reverse side of application to be completed by authorized agent of owner)