17D-036 (9) ZONING •
DISTRICT
FRONT YARD
SIDE YARD
51DE YARD
REAR YARD
IX. SITE OR •
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NOTES and Data — (For department use)
0 A57
r
r
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address Number, street, city, and State ZIP code Tel. No.
Owner or
Lessee
Builder's
2. License No.
Contractor
3.
Architect or
Engineer
I hereby certify that the proposed work is authorized by the otner of record and that I have been authorized by the owner to
make this applicatio 'as his authorized agent an agree toi conform to all applicable laws of this jurisdiction.
Signature of applical6t Address Application date
r,
00 NOT WRITE E L 0 W THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Ions B Date Plans B Notes
9 Fee Star ed y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDIICTION APPROVALS
Date D
Permit or Approval Check Obttai ed Number By Permit or Approval Check obttaitned 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 Use Group
Permit issued 19�
Building Fire Grading
Permit Fee $ �L , t�"?s Live Loading
Certificate of Occupancy $ Occupancy Load
Approve by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�. MASSACHUSETTS
$ e OFFICE of the INSPECTOR of BUILDINGS
Page Op Plot —34 APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT —�(Applicant
t to complete all items in sections: I, ll, III, IV, and IX. O
I• AT (LOCATION) / \JI�Y ��1�1 � , t {,��_. ZONING u�a
y � ;_f` i� DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN f hk_" , "L��1.--�— 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 dNew 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— — — — 20❑ Industrial
3 ❑ Alteration (See 2 above)
14 ❑ Transient hotel, motel, 21 C� Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
❑ 22 L� Service station, repair aro e
5 Wrecking (1l multifamily residential, o/ unzts ------- — -i p g g
enter number of units in building in 15 ❑ Garage 23❑ Hospital, institutional
Part D, 13)
6❑ Moving (relocation) 16 F—] Carport 7 / � 24❑ Office, bank, professional
17 ❑/ Other — Specify �1 Ji _ 25❑ Public utility
7❑ Foundation only
26 ❑ School, library, other educational
Stores, mercantile
27
B. OWNERSHIPS ❑
8 [:�j Private (individual, corporation, 28❑ Tanks, towers
nonprofit institution, etc.) 29❑ Other — Specify
90 Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food
;t CJ 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
30 Masonry (wall bearing) 40 ❑ Public or private company 48. Number of stories.............
31 Wood frame 41 ❑ Private (septic tank, etc.) 49• Total square feet of floor area, f!)
all floors, based on exterior
32 ❑ Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other — SpeciJy 42 ❑ 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 Electricity 44
❑ Y e s 45 No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevators 54. Number of Full..........
46
[--1 Yes 47 ❑ No bathrooms
Partial........
i
__
., _
i
.. r; ,
DEPT. OF BUILDING INSPECTIONS BUILDING ZQ
2
! 212 Main Street 'oa /0
Northampton, MA 01060 PERMIT
17D - 36 VALIDATION
DATE Apri 1 7, lg 87 PERMIT NO. 166
APPLICANT Kathy Tetreault ADDRESS 7 inner Ave. , Florence wner
IND.) (STREET) (CONTR'S LICENSE)
New Bu i 1 d i n_ Storage Shed NUMBER of
PERMIT TO g (_) STORY. DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION)
27XAXX Sumner Ave. Florence ZONING
DISTRICT URB
(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 new storage shed
VOLUME 120 sq. ft. ESTIMATED COST $ 100.00 FEE PER
, 10.00
(CUBIC/SQUARE FEET)
OWNER Same as Applicant Q�4
BUI
ADDRESS Same as ARp1 Scant' s BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY - PINK - ASSESSORS COPY P'iRoP