17C-222 (12) ZONING •
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
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NOTES and Data
r � 7ld
IV
lj G
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel.0 P4 o.
Owner or
Lessee
Bui Ider's
L.
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.
SWin of applicant / Address Application date
oo
�2 I
DO 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
Date Date
Permit or Approval Check Obtoi ed 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 l/
Bui(ding- Use Group
Permit issued 19 55
Building ee Fire Grading
Permit Fee $ �1
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved y:
Drain Tile $
Plan Review Fee $
TITLE
for ti CITY OF NORTHAMPTON
MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page 7 If 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
ZONING
I• AT (LOCATION) j **''' I n,J ' -,{t 2 (j DISTRICT
LOCATION NO.) STR Er'
OF BETWEEN -.ice wm+'�iE'C•'� AND I�C)•Y'% _c7yG "'i;itG'Ci
BUILDING (CROSS STREET) (CROSS STREET)
LOT nG.r�r
SUBDIVISION LOT BLOCK SIZE 125�:11'J t
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 D New building Residential Nonresidential
2 E-1 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 n Industrial
3 >< Alteration (See 2 above)
14 C� Transient hotel, motel, 21 Parking garage
4 Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (If multifamily residential, of units ——————— — --f 22 ❑ Service station, repair garage
enter number of units in building in 15 n Garage 23 Hospital, institutional
Part D, ]3)
16 Carport 24 Office, bank, professional
6 n Moving (relocation)
7 n Foundation only 17 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 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.
7'o be ir..stalled 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 $ it J17! 0
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 0,41e
30 Masonry (wall bearing) 40'�WPublic or private company 48. Number of stories................
31 Wood frame 41 D Private (septic tank, etc.) 49. Total square feet floor area,
all floors, based on n exterior 00(�n
32 Structural steel dimensions .....................
33 Reinforced concrete H. TYPE OF WATER SUPPLY
50. Total land area, sq. ft. ... / �ZO
34 `� Other — Specify 42 Public or private company """"
43 Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
PRINCIPAL TYPE OF HE T G FUEL I. TYPE OF MECHANICAL 51. Enclosed .......................
F. PR 1 Gas ��� �� {1� Will there be central air 52. Outdoors........................ S
36 '1 Oil /1 conditioning?
_ _ L. RESIDENTIAL BUILDINGS ONLY
37 L- t Electricity 44 Yes 45 No 53. Number of bedrooms..............
38 Coal
39 j Other — Specify Will there be an elevator° Full..........
_ 54. Number of
[ f bathrooms
46 � Yes 47 ',`_ No Partial........
INSPECTION RECORD
DATE NOTE PROGRESS - CRITICISMS AND REMARKS (" INSPECTOR
or W10=4 ugpwfmm FIELD COPY
212 mm sram BUILDING
>I 0101,2119JO!"Ma MA. 01M PERMIT
17C - 222
DATE immun as 1991 PERMIT NO.
APPLICANT fin: ADDRESS 131 malsk st rss
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO ,A �I�IC OME (�) STORY— I s DWELLING UNITS I
(TYPE OF IMPROVEMENT) NO, (PROPOSED USE)
ZONING
AT (LOCATION) DISTRICT
(N0,) STREE
rn BETWEEN -AND
(CROSS STR (CROSS STREET)
LOT
IL
IL SUBDIVISION L BLOCK SIZE a
}
a 3
O
O BUILDING IS TO BE FT, WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
` m I
!I O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
7 i ,�[ of !
0 REMARKS: 'i!� � ")E"✓l t IL odts to 1� m i� *%M% �t 44Qft. of R 60 ita t
tltall t�lti t is t a s rMft4M* Of tbt OW" It"" f Ot
AREA OR PERMIT.�_ *?
VOLUME ESTIMATED COST $ ,c=rs __ FEE
(CUBIC/SQUARE FEET) !
i
)
OWNER !_tf�t� # I f
ADDRESS #'34 itrtw Cirr►w�.f 1�'lass+aww.r Mw 1l� 1!(tf1 B {l.° ✓!/