17C-285 (6) ZONING •
FRONT DISTRICT
SIDE YARD SIDE YARD 4
REAR YARD
NOTES
IX. SITE OR PLOT
For Applicant Use
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants .4
/Name �y Mailing address — Number, street itv, and State y� /Z�IPyrycode Tje!.`No..
Owner or -- 1 i�! / 40`„ h ! / V ' /yl/
Lessee
Builder's
2. � � � i tj, 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 of a plicant � - Address Applic lion date
/i''1
00 NOT WRITE 6 E L 0 W THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans By Notes
Fee Start*d y Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obta ned 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 3 >77
Building. / Use Group
Permit issued ((tG?� 19 _
Building Fire Grading
Permit Fee $ OlJ l�� Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
/r
TI .
J
$11,14, CITY OF NORTHAMPTON
g� + A MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page Plot APPLI CATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
yyyy ` C DISTRICT
I• AT (LOCATION) `-� � �
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 ;0
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
m
-1
1 ❑ New building Residential Nonresidential
2 ❑ Addition(If residential, enter number 12 One family 18 ❑ Amusement, recreational
of new housing units added, if any, ��
I Part D, 13) 13❑ Two or more family — Enter 19 ❑ Church, other religious
number of units— — — — 20 ❑, Industrial
3 Alteration (See 2 above) 14 l
Transient hotel, mote ,
❑ 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 El Wrecking (It multifamily residential, of units ——————— — --i► 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 — SpeciJy/& ��-�°`� :dads 25 ❑ Public utility
7 ❑ Foundation only J }
) 26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
❑
B Private (individual, corporation, 1 � e �
28 Tanks, towers
1
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.
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
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
3 Masonry (wall bearing) 401 Public or private company 48. Number of stories......'
31 Wood frame 41 ❑ Private (septic tank, etc.) 49• Total square feet of floor area,
a•„" all floors, based on exterior
32 ❑ Structural steel dimensions .....................
33❑ Reinforced concrete H. T E OF WATER SUPPLY
34❑ Other — Specify 4? ,•Public or private company 50. Total land area, sq. fT. ..........
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 ❑ Gas Will there be central air 52. Outdoors........................
362 Oil conditioning?
�.�� L. RESIDENTIAL BUILDINGS LY
Electricity 44 ❑ Yes 45 y,,?'I No 53. Number of bedrooms..... � .
38 ❑ Coal
39❑ Other — Specify Will there be an elevator?N Full..........
54. Number of
46 ❑ Yes 47 Lilo bathrooms
Partial........
DEPARTMENT OF BUILDING INSPECTIONS
112 MAIN STREET BUILDING o a �k' ,CA //J //Gf' ��� `s/
NORTHAMPTON, MA, olobo PERMIT Qa v L/ /
i'7 p
17C - 285 VALIDATION
DATE August 10 19 $Z PERMIT NO. 377
APPLICANT wi 11 i am i Haydenn ADDRESS 32 1 uV
(NO.) IS A EET (CONTR'S LICENSE)
NUMBER OF
PERMIT TO ( 1 STORY � gyagg DWELLING UNITS
TYPE 0 MP 0 N (PROPOSED USE)
AT (LOCATION)
I,i]_lV __ DISTRICT
URB
(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: Masnnary., Chimney & wand furnace installation (exterior chimney)
AREA OR ESTIMATED COST $ 750-00 FEEMIT 10.00
VOLUME
(CUBIC/SQUARE FEET) /AJ
OWNER
William L Hayden BUILD
ADDRESS 12 Lilly Street} No 411, Ma. 01060 By
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY PINK - ASSESSORS COPY