23C-080 (4) Tafi^p c)t
1:0. Lv
APPLICATION
Zoning Ordinance Section 10.2 I'eccived: File 110. 11,1n rile
D,sner lAnk AA-i t _Amt:- Ap-plicant AeAmoA Qnc!J&,u Since
Address 9a, bliss Sf' iu2aatce Address 4Q 1,I4j
relephbne Telephone -py-�r7�
This section is to be filled out in accordance ti.ith the "Teble of Dir..qciisionnl and
Density Regulations:. (Z. ARTICLE VI)
Zoning Use EA4,re
Front Depth Setbacks i.�?x.Bld. Min. Op.
District '.7idth Front .Sid zCover. ___S ace
Past Existing - . - % %
resent Propose % %
Mark the appropriate box to indicate the use of the parcel:
[� Non-Conforming Lot ar.d/or Structure. Specify..
( Residential Single Family Unit =Multi-Family
117- Q Duplex =Other
Q Business
Q Industrial
Q institutional
[� Subdivision [_] Regular ED P.U.D.
Q Clunter 0 Other
Q Subdivision with "Approv,l-Not-Renuiredii-Stamp:
Q Planning Board Ap'prova.l:
Q Zoning Board Approval (Special Permit 10.9: Variance)
[�City Council (Special Exception G.. 10.10)
'
Watershed Protection District Uveriny: (Z.O. Sect. ::IV) � Y�'.s Ao
Parking Space Requirements: - (Z.O. ;sect. 8.1) . Required
Loading Space Requirements: (Z.O: Sect. .8.23 Required.erigProjD-ft �
Signs: (Z.O._Art, VII) Q Yes to
Environmental Performance .Standards: (Z,O, Art, XII [=]Yes h'o
i
Plot Plan es Q No Site Plan y Yes Ido
(S. 10,.2) (S. 1.0.2 and 10.11
Waiver Granted:-Date �
This section for OFFICIAL use only: .
=Approval as presented:
[--1I4odific-ations necessary for approval:
[Return: (More information needed)
Q Denial: Reasons:
/,76
Signature of Applicant Date Signaure Admin., Officer Date
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.
f
Application for Permit to Build
Northampton, Mass., .H! !' 1..»1. ?..»........19». l» .
To the Inspector of Buildings:-
The undersigned hereby applies for a permit to build, move, alter, or repair, according to the
following specifications.- /
1. Owner's name ...».................».................................................»............._........................
2. Owner's address .».)I ................
3. Architect's name ... .�F..».....................................................................................................................................................................
4. Builder's name .....»k&.......................»....».».......».................»............................».........._.............»......................»........................».......
5. Builder's address .'y.2:.......klL At
6. Location of Building. Street No. ...' .....! . ... t:..»....: ' ?.. .....».».............».............»............»....» ...»»»...».
7. Is this a removal or new building....am.......01......P.1.4......P..Q.=..........................................................................
8. If removal, from where J.-A4'af....»&!!_.h................»....».
9. What is the purpose of building ..A:�:__LPn er?c .U...........................................................
10. Material of building ... C .....................................».............»............................»....»..................................
11. If a dwelling, for how many families......................................».....Number of rooms ..............»...................................
12. Is there to be a store in the building....Aja...................................................».»....».......»..........»............................................
13. Size of building, No. of feet front .....»..»»...........;No. of feet deep .....»....»..........; 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 .................».».
16. How near the-line of street ................................................................................................................................................................
17. How near the line adjoining lot. Right............................».....; Left...................................; 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 pitched ...........».»....»...........................»....»....; 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) ....LQi.!.»�l ..............................................................................................................
Applicant agrees to give the Inspector of Buildings 24 hours' notice before lathing or
plastering this building. is building will conform to the requirements of the law.
Signatureof applicant .....»... 4.»' ». ». ?...».......»................»....».............»...,..........................».. 1 .....
REMARKS
�.�,,..�. .........»....».».......................................