17C-309 (3) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
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SIDE YARD SIDE YARD
REAR YARD
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address - 10irnber, street, city, and .State ZIP code Tel. No.
O wner or tl� 77tu�
O
Lessee �Uf
Builder's
2. 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 th s app cation as his auth ri ed agent and we agree to conform to all applicable laws of this jurisdiction.
Signature of is t /r Address Applica 'on d e
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 Is
OTHER Is
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
II. VALIDATION
Building / FOR DEPARTMENT USE ONLY
Permit number l>'
Building i - , Use Group
Permit issued �'a 1' ``' "r 9
,r
Building Fire Grading
Permit Fee / j `C:
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $ 0
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
g• MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
Page C Plots APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. 0
� ZONING
I• AT (LOCATION) / DISTRICT
LOCATION / (NO.) (STREET)
OF �fE �-(LL� L,/�NC AND S 1I) & TQA�
BETWEEN
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
A. TYPE QR IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
1 New building Residential Nonresidential
2 ❑ Addition(If 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 19 ❑ Church, other religious
number of units- - - - -p- 20 ❑ Industrial
3 ❑ Alteration (See 2 above)
14 ❑ Transient hotel, motel, 21 ❑ Parking garage
4 ❑ Repair, replacement or ormitory — Enter number
5 ❑ Wrecking (If multifamily residential, o/ 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 E:] Other - Speci/y 25 ❑ Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWN HIP 27 ❑ Stores, mercontile
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
r processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement................ /Q 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 1 E�C> �
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❑ sonry (wall bearing) 40 ❑ Public or private company 48• Number of stories...........
31 ✓Wood frame 41 ❑ Private (septic tank, etc.) Total square feet n floor area, S
all floors, based on exterior
32 ❑ Structural steel dimensions ..................... r
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other - Specify 42 F-] Public or private company 50. Total land area, sq. ft. ...........
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........................
36 ❑ Oil conditioning?
�- / L. RESIDENTIAL BUILDINGS ONLY
37 E] Electricity 44 n Yes 45 ` _ No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other - Specify Will there be an elevators 54. Number of Full..........
46 n Yes 47 �o bathrooms
Partial........
i a DEPT. OF BUILDING INSPECTIONS BUILDING 2000
! 212 Main Street O<
Northampton, MA 01060 PE RMIT
17C - 309 VALIDATION
DATE November 14 g PERMIT NO. 656
Williams APPLICANT Anthony R. W ADDRESS
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO New Building (_I STORY 2 Car Garage/Storage NUMBER NG UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 9 Hillcrest Drive ZONING Ux
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 construction of a 2 car garage/storage area
ARA VOLUME 576 sq. ft. ESTIMATED COST � 10f000•0O FEEMIT .� 40.00
(CUBIC/SQUARE FEET)
OWNER Same as Applicant 0j
BUILDIN D
ADDRESS Same as AT)zi l lrants BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY po.,-fp