17C-279 '?o T�c�L Aar. 0
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o u cs
NOV 12 1986
fl�Pt
E I -
;Vill. ZONING •
FROINT YARD
SIDE YARD SIDE YARD
IX. SITE OR PLOT
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants •
Name Mailing address — Number, street, city, and State ZIP`code Tel. No.
1.
Owner or ' 07 v
Lessee
Builder's
2, L.J-icense 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.
$i nature of applicant Address Application date
00 NOT WRITE BELOW THIS NE
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 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 3� FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued LAS--� 19 _
Building Fire Grading
Permit Fee $ o��.Q
Live Loading
Certificate of Occupancy $ Occupancy Load
d by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�. MASSACHUSETTS
$ e OFFICE of the INSPECTOR of BUILDINGS
T Page �- Plots p APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. tt }}}}}}���� 0
ZONING //28
AT (LOCATION)
DISTRICTT••
LOCATION (NO.) (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
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
m
1 ❑ New building Re,%Ldgntial Nonresidential
2 Addition(If residential, enter number 12 EWne family 18 Amusement, recreational
of new housing units added, if any,
13 Two or more family -- Ertter 2
number of unit 19 Church, other religious
in Part D, 13) � -
`s— — — — —> 20 �] Industrial
3 Alteration (See 2 above) 14 Transient hotel, motel,
21 �] Parking garage I
4 Repair, replacement or dormitory — Ereter number I-
5 �] Wrecking (11 multi/amity residential,
of units 22 ❑ Service station, repair garage
enter number of units in building in 15 Garage 23 �] Hospital, instiwtional
Part D, 13) 16 L� p Car ort ��
24 I Office, bank, professional
6 Moving (relocation)
17 [] other — Spec-1/-v 25 [� Public utility
7 Foundation only _
/�� � 26 L_ J School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 k Private (individual, corporation, !{.� 28 Tanks, towers
nonprofit institution, etc.) 29 Other — Speci/y _____
90 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,,,,,,,,,,,,,,,, &00d_ 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 .......................
c. Heating, air conditioning..........
d. Other (elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT I$ GOOa
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............... Z
49. Total square feet
31 Wood frame 41 Private (septic tank, etc.) floor area,
all floors, based on n exterior
32 Structural steel dimensions .....................
33 Reinforced concrete H. TYPE OF WATER SUPPLY
34 Other — Specify 42 Public or private company 50. Total land ores, sq. 4t. ..........
43 Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 L Gas Will there be central air 52. Outdoors........................
36 Oil conditioning? _ L. RESIDENTIAL BUILDINGS ONLY
37 C� Electricity 44 n Yes 45 No 53. Number of bedrooms..............
38 Cool
39 n Other — .Specify Will there be on elevator? Full..........
54. Number of
46 C � Yes 47 J No bathrooms
Partial.......
DEPT. OF BUILDING INSPECTIONS BUILDING o° ,,�� 0(�)
! 212 Main Street v
Northampton, MA 01060 PERMIT
17C - 279 p VALIDATION
8
DATE June , �g 87 PERMIT NO. 348
APPLICANT Pamela Pomeroy ADDRESS Mea oW treet owner
(NO.) (STREET) (CONTR'S LICENSE)
Addition Rear Porch NUMBER of
PERMIT TO (_) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
21 Meadow Street ZONING URB
AT (LOCATION) DISTRICT
(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 the expansion to the existing rear porch per ZBA Approval
AREA OR ESTIMATED COST 6,000.00 FEEMIT $ 24.00
VOLUME
(CUBIC/SQUARE FEET) •
OWNER Same as Applicant BUI
ADDRESS Same as Applicant' s BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY p'INT SIIP