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17C-173 (4) ZONING • FRONT DISTRICT r SIDE YARD SIDE YARD REAR YARD NOTES Ix. SITE OR PLOT ...................._..... 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No Owner or 'a a'� Lessee / Bui sr 2. LA-1ciJ &Z FC,Q 1-7. LiceneNo. 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 Appli ation 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 B Notes 9 Fee Started y Approved y 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 y�S� Building- Use Group Permit issued 19 Building Fire Grading Permit Fee $ �s (� Live Loading Certificate of Occupancy $ Occupancy Load $ re by: Drain Tile � l Plan Review Fee $ TITLE CITY OF NORTHAMPTON MASSACHUSETTS OFFICE of the INSPECTOR of BUILDINGS Page /7 Plot / 72 APPLICATION FOR INSPECTOR ZONING PERMIT AND BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: 1, 11, III, IV, and IX. O ' ZONING I• AT (LOCATION) DISTRICT LOCATION (NO.) STREET) OF BETWEEN AND BUILDING CROSS STREET) CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE con 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 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, Repair, replacement 21 ❑ Parking garage 4 Re p p or dormitory — Enter number 22 Service station, repair garage ❑ ——————— — 5 Wrecking (I/multifamily residential, o 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 — SpeciJy 25 ❑ Public utility 7 ❑ Foundation only 26 ❑ School, library, other educational B. OWNERSHIP 27 ❑ Stores, mercantile 28 Tanks, towers 8 Private (individual, corporation, ! � 1lL 1 C� �) 1 ❑ nonprofit institution, etc.) 29 Other — SpeciJy 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,,,,,,•.•..,.••• C'C — school, secondary school, college, parochial school, parking garage for, department store, rental office building, office building at industrial plant. 7'o 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 $ 30 C)C 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 n If 30❑ Masonry (wall bearing) 40 ® Public or private company 48• Number of stories................ G 31 Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square Feet of floor area, r 3 all floors, based on exterior 32 Structural steel dimensions ..................... 33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY 34 ❑ Other — Specify 42 V Public or private company 50. Total land area, sq. ft. ........... 43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACESr 51. Enclosed ....................... / F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 35 X Gas Will ere be central air 52. Outdoors........................ 36 Oil condition L. RESIDENTIAL BUILDINGS ONLY 37 ❑ Electricity 44 ❑ Yes 45 ❑ No 53. Number of bedrooms............. 38 ❑ Coal 39 Other — Spccify Will t ere be an elevotor? Full../ _ 54. Number of 46 ❑ Yes 47 ❑ No bathrooms Partial....... ARTMNT OF BUILDING INSPECTIQN5 232 Main Street 0< BUILDING Northampton, Ma, 01060 PERMIT Qa /// 17C - 173 VALIDATION DATE gpp,tpmbpr 22. 19 Al PERMIT NO, 545 APPLICANT Karon Boyal ADDRESS 25 Fairfield ALvenuP (NO.) (STREET) (CONTR'S LICENSE) NUMBER OF l PERMIT TO ( ) STORY DWELLING UNITS E IMPROVEMENT) N0. PROPOSED USE) ZING AT (LOCATION) 2`� Fairfield Avenue DIOSTR CT TW (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE Addition BxYJM IS TO BE 10 FT. WIDE BY 16 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: Solar addition AREA OR s VOLUME ESTIMATED COST $_ FEEMIT 12_00 (CUBIC/SQUARE FEET) OWNER To-gpph Rilyprman - Karen Bey el _ BUI I ADDRESS 95 Fa irfip � Av P p' Fin p CP, Ma- 01060 BY WHITE - FILE COPY • GREEN - FIELD COPY a CANARY - APPLICANT COPY m PINK - ASSESSORS COPY