17C-300 (4) ZONING PERMIT r,
APPLICATION
I �• Lot
Zoning Ordinn►.ce Section 10.1" File I,'o. Flan rile
J;vner \
Address �� '�. � Ad-_lres �,� �
Telephone '.TeleplhnncI-{
This section is to be filled out :i is r1ccord,.nc -J t h U c of Dir.r i>siorir ]. and
Density Reg latione:. (Z.0. A!'T1CLI;
Zoning, 11re I.ot Front Depth tl?n�'• i,ax.BId. I-Tin. Op.
District Area Y;idtII Fruilt 51de ► _Cover; Space _
Past Existin.C,_
resent Propoced
Mark the approprint.e tox to indicate the use of the p,-reel:
QNon-Conformin(; L�,t ':end/or ;'tructure. Sr!ecify.� ___.___._------__.---..__..= -------•. .
( Residcntiol Sint�le F.!ni],y Unit. DI`:ulti-Family
Duplex Q0thei
(Q Business
Q Industrial.
[� Institutinr-1
Q
Subdivision Pei �r] r Q P.U.D.
ther
Q Subdivision iv.i_th
Q Plannirig ?;oard Apprnva.l :
Q Zoning Hoard Approval (Special Perl)lit jo.o: V�ri,lnce)
QQ City Council (especial Exception S. 10.10)
Vatershed Protection District Overlr.y: (U.0. Sect. ._:IV) � Yes C]_I'o
Parkin,; Space Requirement.^,: ",;,)Oct. `'.l) Required Proposed
Loading Space Requirement:: MO. :"ect. 8.2) Required Prol-,ocec?
- IIo
Q Q
Suns: (7,.0, Art. VII) Ye
_
Enyirorunental Performance "tandardr,: ( Y,.0. Art. XJ.I) Q3:es OPIo
Plot Plan Q Yes -- Oite Plan 0 Yes ,,
(S. 10..2) ( '. , 10.2 and 10.11
��::iVE'I' �iI'alltCil: D:lte
Tliis section for OFFICIAL u:e only:
=Approval as p.resentrIA:
QI-lodificationn necessnry for
QReturn: (Ilore informntion n(. tide(j)
[� Deniol.: R r r.ons:
Signature of V !licnnt Date Si ,ii-turc f)f h!lmin. Officer Date
i
I hereby certify that the proposed work ii' authorized by the owner of !record
and I have been authorized by the owner to make this application as his
authorized agent.
SIGNATURE OF AGENT
ADDRESS v
(NUMBER) (STREET) (CITY)
APPROVED .BY TITLE
DATE 19
DEPT. FILE COPY
City of Northampton Z0
Massachusetts B,IJIL�IIVG $a
Office of the Inspector of Bui.ld�gs
PERMIT VALIDATION ''..
DATE 19--7 PE IT NO 3s
APPLICANT ADDRESS
(N0.) (ST E?) - (CONTR'S LICENSE)
NUMBER OF
PERMIT TO (_) STORY, DWELLING UNITS
(TYPE OF IMPROVEMENT) N0. OROPOSED USE)
ZONING
AT (LOCATION) DISTRICT
(NO.) (STREET)
a BETWEEN AND
'o (CROSS STREET) (CROSS STREET)
rn
LOT
SUBDIVISION m SUBDIVISION LOT BLOCK SIZE
Q
p BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
f (TYPE)
0:
O
W REMARKS:
AREA OR
VOLUME ESTIMATED COST $ 40'100 - FEEMIT .
(CUBIC/ OUARE FEET)
OWNER
BUILDI
ADDRESS BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)
i
1W :� o o— ltl,42S
For ALL buildings within Fire District and for other buildings costing$10,000.00 or more,plans
and specifications must be submitted to the inspector of Buildings for examination and approval.
If building is to be moved give details relative to proposed location as for a new building.
Application for Permit to Build
Northampton, ....»........19. =.
To the Inspector of Buildings:—
The undersigned hereby applies for a permit to build, move, alter, or repair, according to the
following specifications.-
;.
� l . .e....... ..•,. ....�........ n:�.:..............1. Owner's name ................... .. ».
'�u.... .... ..M.
2. Owner's address
».......»» °?,.,.: ».:.. »........ ...........................»............».. .................
3. Architect's name ......... ........ ,.4..: . ». .. »....... ..................................................».........................».......
4. Builder's name ...........».»....».....»......»...... :.:...».....».»............................».........................»...............................................
..........................:
5. Builder's address .....»......... !. ......: »....... ....»...............................»....»................».......»........
6. Location of Building. Str_egt._1_q. .................................._.».......i...............................................».............»...................»..................
7. Is this a removal or Cew i lding y.........»........................».............»....».......».............».......................................... ....................
8. If removal, from where ...........».».......»....»..........................»...............................».........................».....................................»..................
9. What is the purpose of building ...... ..... . ....... ............. ............� .....
10. Material of building ............................... �.:.:� ., .: :�..... .`: ..ti. ........ ,: : .�.t..�."f .»......
11. If a dwelling, for how many families ...........» ...»�.r.............»..-...Number of rooms .................::............................... r
12. Is there to be a store in the building ....»...»»...... .»�.�k,\.....� .' .....».»....».......»..........».».............».......».»....»...
13. Size of building, No. of feet front L .........;14b. of feet deep LS..:.».....; No. of stories
14. Size of ell, No. of feet front .......................; No. of feet deep ........................ No. of feet high ...........»............
15. Size of Lot .....».».............»............................»....».......................Feet Wide ...........»..................».. Feet Deep
.................................
r
16. How near the line of street ...................... . ..........................................,..................................».........................................................
17. How near the line adjoining lot. Right...... ........................; Left ;Z....................: Rear....... .:?..................
18. Nearest building is ............................... feet in a.................».................................. direction ......................................................
19. Material of the floor.............................: ..............»............................................................................
20. Size of timbers, 1st ...........»....»....; 2nd/................... ; 3rd .......................: 4th .............................; 5th ................»....».....
21. No. of feet span ...........».............»...........................»............. ; Distance on centers .....»...............................................
22. Will the building be erected on solid or filled land .....».... . ... ....................................................................
23. What is the material of foundation..... :........»....».».....; Footing .......................
24. Will the roof be flat or Jitche_d, ...........».»....»............................»..........; Covering..............»....»....»........................................
25. Heat; steam, hot water, furnace, stoves........................................; Power oil burner .....»......................»................
26. Fireplace .».................».............»..........»......................; Insulation ..............»..............................................................................................
27. How many sinks ............: Toilets .....».....; Lavatories ..».....; Bathtubs.....»..; Showers............; Settubs .........
28. City Service, Water Sewer ...........».....»....; Road Surface ..........................; Sidewalk ........................
29. Is lot on accepted street ..............»....»............»., ...............................................................................................................................
30. Estimated cost (must be filled out) ........ .»................»............................»....»...................»....»..............
Applicant agrees to give the Inspector of Buildings 24 hours' notice before lathing or
plastering this building,h is building will conform to the requirements of the law.
f
Signature of applicant . ......... `
No . ....}.....»................
REMARKS
............................»...................»...............................».»................»........................................................».............».........................»....».».............»..........................