17A-270 (6) ZONING •
DISTRICT
FRONT YARD
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NOTES
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NOTES and Data — (For department use)
i
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, ami State ZIP code Tel. No.
?
1. n(': ('h tf± ;!t?, � � 7 vie",
Owner Owner or 1 n
Lessee i7�r �rt(1 f"o- rin °� l 0 4 0
r r t' ! /T', ( Builder's
L ��CJ1[QQ _ �!;f1aQ.Cr,.(i. �' '� � ' ' License No. `'t
Contractor r
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.
Sign re 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 P y Ions B Date Plans By Notes
Fee Started 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 i
Building- 2 Use Group
Permit issued 19
Building Fire Grading
Permit Fee $ LEZ,
Live Loading
Certificate of Occupancy Occupancy Load
A o d by:
Drain Tile $
I z ,
Plan Review Fee
TITLE
o CITY OF NORTHAMPTON
�• MASSACHUSETTS
r r
e OFFICE of he INSPECTOR of BUILDINGS
!V T
Page Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, It, lll, IV, and IX. O
1 ' ^ _ U
I• AT (LOCATION) DISTRICT
LOCATION (N0.) (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
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use M
M
1 ❑ New building Residential Nonresidential
2❑ Addition(if residential, enter number 12 ❑❑ One family 18 ❑ Amusement, recreational
of new bousing 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
l
t
h
i
Transent hotel, more ,
❑ 21 ❑ Parking garage
454 Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (11 multifamily residential, of units ——————— — —�w 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)
7 ❑ Foundation only 17 ❑ Other — Specify a 25❑ Public utility
26 ❑ School, library, other educational
B. OWNERSHIP �/" V— 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....................... o1 t1
b. Plumbing ..................... u� O --d r,
c. Heating, air conditioning.......... Cad. 4 t)
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 ❑ 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 ❑ 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 1. 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 4.5 No 53. Number of bedrooms..............
38 ❑ Coal
39 Other — Specify Will there be an elevator? Full..........
54. Number of
46 ❑ Yes 47 ❑ No bathrooms
Partial.......
4
y DEPT. OF BUILDING INSPECTIONS BUILDING ZO fr -rr f ff�
+ � 212 Main Street 'a
Northampton, MA 01060 PERMIT
17A - 270 O VALIDATION
DATE January 17, ) v5 (p�g�FjMIT NO. 33
APPLICANT George J. Croteau ADDRESS a ! Ciicopee, ass 02-68 7 11
Fire (N0.) (STREET) (CONTR'S LICENSE)
PERMIT TO Repair. Replacement (_) STORY RM Repair NUMBER NG UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) 116 Oak Street DIISTR CT URB
(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 for interior repairs and replacement with no exterior change
AREA OR
VOLUME existing ESTIMATED COST $ 21,470.00 FEE $ 04.00
(CUBIC/SQUARE FEET)
OWNER Robert Ayotte
> > BOIL .l
ADDRESS BY it
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pit"P