05-044 (3) ZONING •
FRONT DISTRICT
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REAR YARD
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NOTES and Data — (For deportment use)
IV. IDENTIFICATION —,T7 be completed by all applicants
l
Npme Mailing address — Number, street, city, and State ZIP code gel. No
Owner or "
Lessee y
r Bui Ider's
L.
{ L License No.
Contractor
3.
Architect or
Engineer
I hereby certify that the propgsed work is authorized by the owner of record and that I have been authorized by the owner to
make this applica,fion as/his,authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature of applicairt ;t ! 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 Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
ate Date
Permit or Approval Check ObDta ned 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 i FOR DEPARTMENT USE ONLY
Permit number
Bui(ding. Use Group
Permit issued ' 19
Building Fire Grading
Permit Fee $ ��` ' �
Live Loading
Certificate of Occupancy $ Occupancy Load
App ved b'
Drain Tile $
Plan Review Fee $
TITLE
�oR CITY OF NORTHAMPTON
MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page �� Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items ' ections: 1, 11, 111, IV, and IX. 0
ZONING
• AT (LOCATION) DISTRICT❑
_OCATION (NO.r 9TREETI
)F BETWEEN AND
WILDING CROSS STREET) CROSS STREET)
LOT
SUBDIVISION LOT }�— BLOCK SIZE
V1
I. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use rn
rn
1 ❑ New building Residential Nonresidential
2 ❑ Addition(If residential, enter number 12❑One family 18 ❑ Amusement, recreational
of ncu, housing units added, if any,
in Part D, 13) 13 ❑ Two or more family — Enter 19 ❑ Church, other religious
number of units— — — — -� 20 L❑ Industrial
3 Alteration (.Sec: 2 above)
14 ❑ Transient hotel, motel, 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (If multifamily residential, of units ——————— — i 22 Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 Hospital, institutional
Part D, 13)
6 ❑ Moving (relocation) 16 ❑ Carport t h. 24 ❑ Office, bank, professional
17 Other — Specify u( '"° 25 ❑ Public utility
7 ❑ Foundation only i 26 ❑ School, library, other educational
B. OWNERSHIP o J� -47 iL 27 ❑ Stores, mercantile
28 ❑ Tanks, towers
8 ❑�Erivate (individual, corporation, Specify
Other -
nonprofit institution, etc.) 29 ❑ p fy
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,,,,,,,,,,,,,,,, J�
( t. 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.)............. r /
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 ❑ Public or private company 48• Number of stories................ C.
31 Wood frame 41 Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior
32 ❑ Structural steel dimensions ..................... e
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY r
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
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
37F I Electricity 44 � ] Yes 45 71 No 53. Number of bedrooms..............
38 Coal ''
r '
/ + r
39 Other - Specify
�-- ,: vf;) Will there be an elevator? Full..........
54. Number of
'{ 46 Yes 47 11 No bathrooms
Partial......
I hereby certify that the proposed work is authorized by the o)&-r, of record ,
and 1 have been authorized by the owner to make this application bs hls - R'
authorized agent.
SIGNATURE OF` AGENT `
ADDRESS.
(NUMBER) (STREET) (c1TY)
APPROVED BY TITLE
DATE l9
F DEPT. FILE COPY
Department of Building Inspections ZO
in Street BUILDING _ /5. od //t/o
q G�
Northampton, M8. 01060 PERMIT VALIDATION
5 - 44
DATE NevPmher 21. 19_ AO_ PERMIT NO. 695
APPLICANT .john W_ Graves ADDRESS
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Solar Collector (_7 STORY nomestic hat u78tEr DWELLING UNITS 1
(TYPE OF IMPROVEMENT) N0. (PROPOSED USE)
ZONING
AT (LOCATION) 219 AndLbnn Rd. DISTRICT-2R
(NO.) (STREET)
rn BETWEEN AND
b (CROSS STREET) (CROSS STREET)
m
LOT
4 SUBDIVISION LOT BLOCK SIZE
m
a -
O
O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
0
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
2 (TYPE)
IC
LL REMARKS: Construnt free standing sa ar callenter
AREA VOLUME ESTIMATED COST $ . FEEMIT
4 652 �. 15.00
(CUBIC/SQUARE FEET)
OWNER
John W- cz-yes
D
ADDRESS 719 Audubon Rd- F Leedsy Ma. =53
(Affidavit on reverse side of application to be completed by authorized agent of owner)
a
INSPECTION RECORD
DATE NOTE PROGRESS — CRITICISMS AND REMARKS -'INSPECTOR
FIELD COPY
Depart+mt of Bail4ing Inspections
212 Main Street BUILDING
B®rthamptest Ma. OiOO PERMIT
5 - 4►
DATE Noymber 21, 19 an PERMIT NO. 695
APPLICANT Jobs W. Graves ADDRESS 219 Andtj�lbtt Ril•T-Leeds
(N0.) (STREET) (CONTR'S LICENSE)
PERMIT TO Solar Cnjlr-tnr (,7 ) STORY NUMBER OF
01meSL�.t' ]ZQt Water DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ING
AT (LOCATION) 219 A>e>ldub®n Rd DIOSTR CT Blt
(NO.) (STREET
BETWEEN AND
(CROSS STREET) h. (CROSS STREET)
LOT
SUBDIVISION - T BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT LONG FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
iV
' TO TYPE USE GROUP BAS ENT WALLS OR FOUNDATION
C (TYPE)
REMARKS. C mstrwt free standing solar call toy
AREA OR g
VOLUME ESTIMATED COST $ 4:652 FEEMIT 1.1 t AC
(CUBIC/SQUARE FEET) 1.7 V
OWNER ,�j� W. (itiPII
L
ADDRESS - 21.9 A>nAlthan Bd.,- Legg, Ma. 01053