17A-126 (4) ZONING •
DISTRICT
IX. SITE OR PLOT
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NOTES and Data — (For 6epo,oncn, use)
IV. IDENTIFICATION — To be completed by all applicants
Name i Mailing address — Number, stmt, city, and State ZIP code Tel. No.
Owner or
Lessee
Builder's
2. 17tk �. Z 111 le 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.
S*a_ture of applicant Address Application date
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 $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Obtaitned Number By Permit or Approval Check obtaDate
ined 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 FOR DEPARTMENT USE ONLY
Permit number X,
Building
Permit issued / - 19 Use Group
Building l Fire Grading
Permit Fee $ ? Live Loading
Certificate of Occupancy $ Occupancy Load
Approved,by:
Drain Tile
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�. .e MASSACHUSETTS
3 OFFICE of the /INSPECTOR of ILDINGS
Page i z Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, Ill, IY, and IX. O
1 - / ZONING �,/�k
(• AT (LOCATION)
« DISTRICT"`
LOCATION IN .) ( REET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vr
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 ❑ New building Residential Nonresidential
2 ❑ Addition(!/ 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 22 L] Service station, repair garage
5 ❑ Wrecking (11 multifamily residential, of units ——————— — -->
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 ❑ Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑J 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
school, secondary school, college, parochial school, parking garage for.
10. Cost of improvement,,,,,,,,,,,•....
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 $
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 �J< 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 L❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other — Specify 42,N Public or private company 50. Total land ores, 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
❑ es
37 C� Electricity 44 Y 45 '! No
_—: 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevators Full..........
54. Number of
46 Yes 47 D No bathrooms
Partial.......
p , DEPT. OF BUILDING INSPECTIONS BUILDING
+ 212 Main Street 0 �}
Northampton, MA 01060 PERMIT <a
17A - 126 VALIDATION
DATE May 4, g 88 P RMIT O, 278
APPLICANT Eugene J. Sullivan ADDRESS ATTI i ge Rd. , Florence Owner
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO Alteration (_) STORY One Family -DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE) 11
ZONING
AT (LOCATION) 297 Bridge Road, Florence DIISTR CT URA
(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 to install single flu chimney & fireplace, also to install french exterior
door onto rear of existing dwelling
AREA OR
3,500.00 PERMIT s 16.00
VOLUME ESTIMATED COST FEE
(CUBIC/SQUARE FEET)
OWNER "
Same as Applicant
��� 'UILD
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ADDRESS BY _ 'E / Algh WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY • PINK - ASSESSORS COPY PINT P