17C-196 (7) ZONING
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
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IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and Star,- ZIP code Tel. No.
Owner or
Lessee
Builder's
2. License No.
Contractor e
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 tur%a applican 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 $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number By Permit or Approval Chec Date Number 8
Obtained Obtained 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
II. VALIDATION
Building ' FOR DEPARTMENT USE ONLY
Permit number
Building. - use Group
Permit issued ��—} 19 t
Building Fire Grading
Permit Fee $ y5of-t 6 d Live Loading
Certificate of Occupancy $ Occupancy Load
Appro by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
g - r MASSACHUSETTS
$ OFFICE of the , INSPECTOR of BUILDINGS
wt Page ` Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
I•
ZONING
AT (LOCATION) Z r� in/ i� ���/' Q �
7 / � DISTRICT -�+
LOCATION —� (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
CA
11. 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 housing units added, if any,
in Part D, 13) 13 ❑ Two or more family - Enter sr/ 19 L� Church, other religious
number of units- - - - 20 ❑ Industrial
3 Alteration (See 2 above)
14 ❑ Transient hotel, motel, 21 ❑, parking garage
4 Repair, replacement or dormitory - Enter number
5 ❑ Wrecking (If multifamily residential, of 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)
17 ❑ Other - Speci/y 25 ❑ Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8 Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 ❑ Other - Specify
9 L-] Public (Federal, State, or
loco[ 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' ) ,? 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 ..................... �'L)L
c. Heating, air conditioning.........
d. Other (elevator, etc.).............
n7 j
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 /2..
49
30 Masonry (wall bearing) 40 Public or private company • Number of stories.......area, . ry J�
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. ........... f
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........................
� ❑
conditioning?
_ L. RESIDENTIAL BUILDINGS ONLY
rrrr"��'"'
37 Electricity 44 Yes 45No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other- Specify Will there be an elevator? Full.......... J
54. Number of
46 ❑ Yes 47A No bathrooms
- Partial.......
a DEPT. OF BUILDING INSPECTIONS BUILDING Z°-
212 Main Street 0 a $240.00
Northampton, MA 01060 PERMIT
23A-78 17C - 196 VALIDATION
DATE February 18, 19 86 PERMIT NO. ML -14
APPLICANT Cecil I/Clark ADDRESS ocklan Seights
Mixed 1�gg. BuSirjg gET) (CONTR'S LICENSE)NUMBER 1 existing
PERMIT TO alp
Addition/Alteration/Rq STORY S DWELLING UNITS TMOMMU
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)__ ZONING
AT (LOCATION)
145 XXXX Main Street, Florence__ DIISTR CT GB
(N0.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS. permit is for the renovation of existing space to be used as mixed residential and
retail Business
AREA OR 1720 sq. ft. ESTIMATED COST .$ 75,000.00 FEEMIT 240.00
VOLUME
(CUBIC/SQUARE FEET) �.� �
OWNER Same as Applicant �ICYD'� °-'
Same as pp ican s BY D1
ADDRESS
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pINT Rp