17D-068 (3) I -— M I
Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
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
Name G Mailing address — ;Number, street, }city, and State ZIPycode Tel. No.
1.
Owner or nrj/✓ �• V 5 fif.� ` �. i) l i�//Q!`J U1060
Lessee
Builder's
2. /,; License No.
Contractor
3.
Architect or C
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.
Signatur f applicant Address Application date
VW DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date P y Plans B Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL Is
OTHER Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number B Permit or Approval Check Date Number pp Obtained y pp N b By
y
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 1 ` FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued t 19 13 A
Building //�� Fire Grading
Permit Fee $ "0
Live Loading
Certificate of Occupancy $ r Occupancy Load
$ Appr b
Drain Tile
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�. MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
N T
Page — Plot_ fit.!? APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, II, III, IV, and IX. 0
`�'� ZONING
I• AT (LOCATION) !(ry 07/ DISTRIC
LOCATION (NO.) (STREET)
OF 5 AND / �
BETWEEN / i /} J�
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 D New building Residential Nonresidential
20 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 r� Parking garage
4� Repair, replacement or dormitory—= Enter number Wrecking (Ii 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 L7 Carport 24 Office, bank, professional
6 Moving (relocation)
17 Other — Specify 25 Public utility
7 Foundation only 26 School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
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
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement•••••••••••..... �L7 CJ school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office buildiryg 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 �taC>Cf' li �' !/ J• �.
c. Heating, air conditioning........
\ 1'
d. Other (elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT $ 000
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 N Public or private company 48. Number of stories................
31 Wood frame 410 Private (septic tank, etc.) 49. Total square Feet of floor area,
all floors, based on exterior
32 Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 Other — Specify 42 Public or private company 50. Total land ores, sq. ft. ........... S coo Ef
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 Wil! there be central air 52. Outdoors........................
conditioning?
36 Oil L. RESIDENTIAL BUILDINGS ONLY
37 E j Electricity 44 Yes 45 !)< No
53. Number of bedrooms..............
38 I Coal
39 Other — SpeciJy Will there be an elevators Full..........
54. Number of
46 [_1 Yes 47 )�,No bathrooms /I
Partial....... �(�
DEPT OF BUILDING INSPECTIONS BUILDING �'° C
212 Main Street Oa
Northampton, MA 01060 PERMIT
17D - 68
VALIDATION
August 2, 88 494
DATE 694-ter--sr. PERMIT NO.
Owner
APPLICANT David Travers ADDRESS
(N0.) (STREET) ICONT R'S LICENSE)
ti
l
Ateraon$ (_) STORY One Family UMBER OF
PERMIT TO y DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION)
23 High Street DIISTR CT
(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 remodeling existing kitchen and bath
AREA OR 10,0 MIT 28.00
VOLUME ESTIMATED COST $ �F E .�
(CUBIC/SQUARE FEET)
OWNER navid TravPre R Karen Red Travers
BUILDWIE
ADDRESS _ m BY
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY • PINK/ASSESSORS ASSESSORS OPY p}NTSIIp