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SIDE YARD SIDE YARD
IX. SITE OR PLOT PLAN For Applicant Use
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NOTES and Data — (For deportment use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code ffTel.Owner or c O1os3
Lessee
Builder's
1' 6 License No. 7
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 d e
DO 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 $
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number By Permit or Approval Check B Date Number
Obtained Obtained 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
Bui Iding Use Group
Permit issued 19
Building Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�. MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page y Plot APPLICATION FOR
V T
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. C)
• A T (LOCATION) y� ZONING
DISTRICT/�.,-
_
LOCATION 13.7 (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D ;0
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
1 New building Residential Nonresidential
2 Q Addition(!/ residential, enter number 12 D One family 18 Amusement, recreational
of new housing units added, if any, 13 F__] Two or more family — Enter 19 ❑ Church, other religious
in Part D, 13) number of units— — — — i 20 n Industrial
3 ❑ Alteration (See 2 above) 14 Transient hotel, motel,
❑ 21 Parking garage
4 Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (11 multi family residential, of units ------- — 22 �� Service station, repair garage
enter number of units in building in 15 Garage 23 Hospital, institutional
Part D, 13) 16 ❑ Carport 24 ❑ Office, bank, professional
6 ❑ Moving (relocation) 25 ❑ Public utility
17❑ Other — Speci fy
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 of hospital, elementary
10. Cost of improvement................ $,2 j S secondary school, college, parochial school, parking garage for,
department store, rental office building, office building at industrial plant.
To be installed but not included If use of existing building is being changed, enter proposed use.
in the above cost
a. Electrical....................
b. Plumbing ....................
c. Heating, air conditioning..........
d. Other (elevator, etc.)............. +�
11. TOTAL COST OF IMPROVEMENT I$��7�OC/
111. 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
48. Number of stories...........
30 17 Masonry (wall bearing) 40 ❑ Public or private company
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 /
42 Public or private company 50. Total land area, sq. ft. ........... W a
34❑ Other — Specify ❑ p p y
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY �}
37 ❑ Electricity 44 ❑I Yes 45 No 53. Number of bedrooms.............. (j
38 ❑ Coal
39❑ Other — Specify Will there be an elevator? 54. Number of Full.......... d
--
46 r � Yes 47 :i�No bathrooms
Partial.......
pp Date Filed ;? File No,
U /
L 7 7 ZONING PERMIT APPLICATION
zoning Ordina4ce Section 10 , 2
1 , Name of Applicant :
Address : Telephone
2 , Owner of Property : X
Address : Telephone :
3 , Status of App.lS.cant : ./ or1ner. Contract Purchaser
Lessee Other (explain : )
4 , Parcel Identification ; oning Map Sheet, Parcel# 01
Zoning Districts)
Street Address
5 , Compliance• with Zoning ; Existing Prop, sed
Use of Structure/Property
Size of Structure (su. ft . ) .:
Building height
r
Building Coverage
Setbacks - front L�
/.
- ,side
rear '
Lot Size
Frontage
Floor Area Ratio
Open Space
Parking Spaces -,
Loading Spaces
Signs '
Fill (volume & location)
6., 'Narratite Description of Proposed Work/Project : (Use '
addita,dnal sheets if/necessary)
_
Lo".
7 , Attached Plans : --/Sketch Plan r . Site Plan
8 , Certification : I hereby certify that the 'ih�prmation. oontained
herein is true and accurate to the best of my knowledge ,
Date : Applicant ' s Signatur -
THIS SECTION FOR OFF2C2AL USE O11LY -' — —
Approved as presented
Denied as presented
Reason for Denial :
y
Signature of Building inspector,. a
J
r
� FF
l
t
Cit of Northam ton REQUIRED INSPECTIONS
s �rt y p
$ e 1 . Footings and Walls
�►
2 . Structural Components in
BUILDING DEPARTMENT place
3 . Complete Building
No. 106 Office of the Building Inspector
Date MARCH 20 19 91
YJ/
BUI, DING P RMIT
THIS MAY CERTIFY THAT RICHARD CARNES Insp. on Site — Foundations
Construct a 2-car gargae w/ breezeway
has permission to w/ OK from conservation commission Insp. of Plumbing — Rough
situated on 277 AUDUBON ROAD Insp. of Plumbing — Finish provided that the person accepting this permit shall in ever re- �`'
P P P g P Y 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
d is an immediate revocation of this permit. Expires six Building Insp. — Rough
note p P
months from date of issuance, if not started. Building Insp. — Finish 1414 .6#�--
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 MUSSTSf MUSTS YED IN A CONSPICUOUS PLACE ON THE PREMISES
Certificate of Occupan
—� Building Inspe
21111Ww' ',".V'1141141