17A-244 (12) ZONING •
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
IX. SITE OR PLOT
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MOTES and Data — (For deportment use)
Ala
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — `'umber, stmt, city, and State ZIP code Teel, Pllm. `
1.
Owner or
Lessee
Builder's
L.
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 gn u of applicant-71
pplicant 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 By Notes
Fee Started y Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
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 .� 7
Building Use Group
Permit issued _ -/ 19
Building Fire Grading
Permit Fee $ —/Z 1�w
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee
TITLE
�P CITY OF NORTHAMPTON
MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT '
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING
AT (LOCATION) DISTRICTLA
LOCATION ("O•) (STREET)
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 Reside tial Nonresidential
2 ❑ Addition(If residential, enter number 12 One fami I 18 ❑ Amusement, recreational
of neu) bousing units added, if any,
in Part D, 13) 13 Two or more family — Enter 19 ❑ Church, other religious
3� Alteration (See 2 above) number of units— — — — 20 ❑� Industrial
14 ❑ Transient hotel, motel,
4 Repair, replacement or dormitory — Enter number 21 ❑ Parking garage
f
5 Wrecking (It multifamily residential, o 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) -
�i 25 ❑ Public utility
7 ❑ Foundation only 17 Other — Specif1CZL26 ❑ School, library, other educational
B. OWNERSHIP jj 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 $ 9�0 Ov
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 XPublic 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 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 N'Gas Will they be central air 52. Outdoors........................
36 [7 Oil conditionin
L. RESIDENTIAL BUILDINGS ONLY
37 j Electricity 44 ;th Yes 45 r No
53. Number of bedrooms..............
38 ❑ Coal
39` e0ther — Specify Will e b e an elevator? Full..........
I�
47 a 54. Number of
46 Yes No bathrooms
Partial......
INSPECTION RECORD
DATE NOTE PROGRESS - CRITICISMS AND REMARKS INSPECTOR
1
DFPARTNUT OF NUXIM INSFSCTIONS FIELD COPY
2ixar STRIMT BUILDING
TtiAt�AV=p NA. 02060
PERMIT
27A - 2"
DATE cletablr 1. 19 80 PERMIT NO. 5127
APPLICANT tE'!V aftutb4Zltt! ADDRESS 82 Lake
(N0.) (STREET) (CONTR'S LICENSE)
_+—� NUMBER OF
PERMIT TO OA 1 iti Ste" (�) STORY For T ma&b1t'Ygf 'd'tAYB DWELLING UNITS 2
(TYF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) $2 Lake DISTRICT un
(NO.) (STREET)
rn BETWEEN AND
(CROSS STREET) (CROSS STREET)
m
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
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
r+ (TYPE)
0:
° REMARKS' Install interior 'block Se brick chiLm+ey and install mood-burning Stowe
in first floor living ro=.
AREA OR VOLUME ESTIMATED COST $ 900.00 FEE
MIT 20.Q0
(CUBIC/SQUARE FEET) 'f `
OWNER Barry Bootbilette �f
ADDRESS 82 Lake Street, Eioreacs.
Ma. 01060 BY'L NG D f}T, ,�
hereby certify that the .
y y proposed, work is authorized by the owner of.roco�d _ r
and I have been authorized by the owner to make this application as his
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
DEPARTMENT OF BUILDING INSPEC`1'IONS � DEPT..FILE COPY
ZO
212 MAIN STREET BUILDING
NOR��T4N, MA, 01060 PERMIT
VALIDATION
17A • 244
DATE October 1„ 19 80 PERMIT NO. 527
APPLICANT Barry Rputyi,lette ADDRESS 82 T ako
(N0.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO (�_) STORY DWELLING UNITS 1
OF IM RO EME NT NO. (PROPOSED U )
ZONING IiZB
AT (LOCATION) 82 - - T.»ke - -- -- DISTRICT
(NO.) (STREET)
a BETWEEN f, AND
�o (CROSS STREET) (CROSS STREET)
a
LOT
IL SUBDIVISION T BLOCK SIZE
U BUILDING IS TO BE FT. WIDE B T�BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
1
O USE GROUP ASEMENT WALLS OR FOUNDATION
Z TO TYPE (TYPE)
LL f
REMARKS: 1nQtall intgrinr hinck & brick chimney and install wood burning stove
in first floor living room.
AREA OR ESTIMATED COST FEEMIT 10.00
VOLUME
(CUBIC/SQUARE FEET) 4D .
OWNER AArry Rout-bilettga _ BUIADDRESS 82Lake RtrPEt, Ain ence. Ma. 01060 BY
(Affidavit on reverse side of application to be completed by auth of owner