31B-190 (4) ZONING •
FRONT DISTRICT
SIDE YARD SIDE YARD
REAR YARD
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N06TES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants 4 a e
Name Mailing,address — Number, street, city, and Statr ZIP code Tel. No.
Owner or
Lessee
' 6 4/=` Builder's
2. 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.
Signature f appli 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 B Date Plans B Notes
9 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER is
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 tlC /J
Bul Iding- Use Group
Permit issued 19 _
Building Fire Grading
Permit Fee $ 1�Oi 4l,
Live Loading
Certificate of Occupancy $ Occupancy Load
Appr d by: Vt'
Drain Tile $
-ti
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
"e MASSACHUSETTS
' OFFICE of the INSPECTOR of BUILDINGS
'"' Page Plot 1170 — APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O
ZONING
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(1/residential, enter number 12 ❑ One family 18 ❑ Amusement, recreational
of new bousing units added, if any, 13 ❑ Two or more family — Enter 19 Church, other religious
in Part D, 13) number of units— — — — -->
3 Alteration (See 2 above) 20 ❑ Industrial
14 ❑ Transient hotel, motel, 21 ❑ Parking garage
4 Repair, replacement or dormitory — Enter number
5 Wrecking (If multifamily residential, of units ——————— — --)0. 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 [7] Other — Specify 25 ❑ Public utility
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8 ❑ Private (individual, corporation, 28 Tanks, towers
nonprofit institution, etc.) 29 KOther — Specifyk�
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
`� school, secondary school, college, parochial school, parking garage for,
10. Cost of improvement,,,,,,,,,,,,,,,,
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 ..................... s
c. Heating, air conditioning..........
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 I. 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 45 FX 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.......
DEPARTMENT OF BUILDING INSPECTIONS
21PMAIN STREET BUILDING Z° �n�, ;l4 �
NORTHAMPTON, MA. 01060 Oa /�3
�" I
PERMIT 4
31B - 190
VALIDATION
DATE October 30, 19 81 PERMIT NO. 609
APPLICANT Alhort maaf-,a ADDRESS_tAO Nnrt-b Rte Hatfield
(NO.) (STREETO (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Alteratioi3 ( 'I ) STORY Playroomc A, phgervadon DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) R Trumbull goad DISTRICT HR
(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:
and observation rooms.
AREA OR PERM T
VOLUME ESTIMATED COST $ FEE
(CUBIC/SQUARE FEET)
OWNER Children's Aid & Family Service :
ADDRESS 8 Trumbull Rd_ , NorthamptoV,Ma_ 01060 BYI
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY PINK ASSESSORS COPY