17D-005 (4) ZONING •
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
1.
Name / Mailing address {- Number, street,�citity, and State ZIP code Tel. No.
Owner or /� t$ •OJ`//✓ U 1ZI A!,/ i� Dume
Lessee
Builder's
2. o5r fly 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 applic tion as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature of appli an Addres(s� Application date
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plan Review Date Plans Date Plans
Plans Review Required Check Fee Started By Approved By Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL Is
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Permit or Approval Check Obtained Number By Permit or Approval Check 06tta tned 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
Building r Use Group
Permit issued j� 7 19
Building � Fire Grading
Permit Fee $_ ts,,
Live Loading
Certificate of Occupancy $ Oc p ncy Load
Approved b _ ,rte
Drain Tile
$ turf --''"
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
Page �,T? Plot 4f—C APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete
,(�all items in sections: 1, 11, 111, IV, and IX. O
I• AT (LOCATION) VV� 1-39Y /��C ' ZONING
DISTRICT
LOCATION IN 0.) (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. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
m
1 [XNew building Residential Nonresidential
2 Addition(If residential, enter number 12 ❑ One family 18 Amusement, recreational
Of new bousing units added, if any,
in Part D, 13) 13 Two or more family — Enter 19 Church, other religious
number of units- — — — > 20 C� Industrial
3 Alteration (See 2 above)
14 Transient hotel, motel, 21 Parking garage
4 Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (1f multifamily residential, of units ——————— — -- 22 �� Service station, repair garage
enter number of units in building in 15 Garage 23 Hospital, institutional
Part D, 13)
16 E Carport 24 Office, bank, professional
6 Moving (relocation)
17><Other — Specify.�1/�?1 � 25 Public utility
7 Foundation only
T�^ /,� 26 � School, library, other educational
B. OWNERSHIP 7G �15 �/ 27 Stores, mercantile
8 Private (individual, corporation, ` l Q 28 �� Tanks, towers
nonprofit institution, etc.) hA/SC.hG1� J'Qe�s 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,,,,,,,,,,,•,.,. 3W r&V 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 /Y
a. Electrical..................... "Ylr77 C n�C_ JCL 2).
�J
b. Plumbing ..................... s ,
c. Heating, air conditioning.......... -A/
d. Other (elevator, etc.)............. /
11. TOTAL COST OF IMPROVEMENT $ 6y'�
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 SEXAGE DISPOSAL J. DIMENSIONS
30 u Masonry (wall bearing) 40 ub i'f c e private company 49. Number of stories.......area, ..
31 Wood frame 41 n Private (septic tank, etc.) 49. Total square feet of Floor area, 17
all floors, based on exterior
32 Structural steel dimensions .....................
33 Reinforced concrete H. TYPE OF WAT ��PLY
34 n Other — Specify 42 Public r prly tt company 50. Total land area, sq. ft. ...........177,
43 Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed ..........l..Y.. I ....
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 El Gas Will there be centrol � 52. Outdoors........................
36 Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 j Electricity 44 ` Yes 45 _ No 53. Number of bedrooms..... ..
38 Coal
39 Other — Spccify Will there be an elevators Full..........
54. Number of
46 r Yes 47 No bothrooms '
Partial.......
- DEPT. OF BUILDING INSPECTIONS BUILDING oa
212 Main Street /
Northampton, MA 01060 PERMIT
17D - 5 VALIDATION
DATE Sent_ 14 -3L9� ffRMIT NO. 598-
APPLICANT James R. Sullivan ADDRESS
(NO.) (STREET) (CONTR'S LICENSEI OF
New Building Storage Shed DWELLING PERMIT TO STORY UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
RR
AT (LOCATION)
550 Bridge Road DIOSTR CT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION p LOT BLOCK SIZE
BUILDING IS TO BE 8 FT. WIDE BY 12 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
lrrPEl
REMARKS, permit for the XKKXXXXXXXK construction of a storage shed
AREA OR 96 sq. ft. 350.00 PER 10.00
VOLUME ESTIMATED COST $ FE
(CUBIC FEET)
Same as Applicant
OWNER BUI N T
ADDRESS BY
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY • PINK - ASSESSORS COPY p-RI P