29-456 (6) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
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BOCA FORM APEBP — 669 01969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
IV. ENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP gcode Tell. No.
Owner or
Lessee C-' 7S
B u i Ider's
2 License No.
Contractor
3.
Architect or
Engineer I F_ I
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.
Signature of applicant Address Applic tion date
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re wired Check Plan Review Date Plans By Date Plans By Notes
9 Fee Started Approved
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER
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_
VII. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number >
Building 5 Use Group
Permit issued 19 7
Fire Grading
Building
/ � 1
Permit Fee . _6 ''. Live Loading
Occupancy Load
Certificate of Occupancy
Approved by:
Drain Tile
Plan Review Fee $ ry
TIT E
NOTES and Data — (For department use)
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 PLAN EXAMINATION AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING A
I• AT (LOCATION)
• �..�. - DISTRICT
LOCATION (NO') IS REET)
OF BETWEEN AND_
BUILDING (CROSS S REET) / } (CROSS STREET) j /U y
/„! LOT I1 Lr7�1
SUBDIVISION A � LOT X/IIOO BLOCK SIZE if
V1
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D A
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
m
1 ew uilding Resident' I Nonresidential
2 ❑ Addition(If residential, enter number 12 One family 18 ❑ Amusement, recreational
of new housing units added, if any, 13 ❑ Two or more family — Enter 19 ❑ Church, other religious
in Part D, 13)
number of units— — — — --)-_ 20 ❑ Industrial
3 ❑ Alteration (See 2 above) 14 Transient hotel, motel,
❑ 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (I/multifamily residential, J units ——————— — 22 ❑ Service station, repair garage
enter number of units in building in 15 ❑ of 23 ❑ Hospital, institutional
Part D, 13) 16 ❑ 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 [�7Private (individual, corporation, f 28 ❑ Tanks, towers
nonprofit institution, etc.) yCl 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,•,,,•,••....... �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 ���
a. Electrical.....................
b. Plumbing ..................... 5 F a
c. Heating, air conditioning.........
d. Other (elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT $vZ 1
III. SELECTED CHARACTERISTICS OF BUIL ING — 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 / ?1Z
48. Number of stories...............
30 Masonry (wall bearing) 40 lic or private company
31 Wood frame p 49. Total square Feet n floor area,
41 Private (septic tank, etc.) all floors, based on exterior /l Q
32 ❑ Structural steel dimensions ..................... Uc N
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
50. Total land area, sq. ft. ...........
34❑ Other — Specify
42 Public or private company
43 ❑ Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed ......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37❑ Electricity 44 ❑ Yes 45 No 53. Number of bedrooms..............
38 ❑ Coo I
39 ❑ Other — Specify Will there be an elevator? 54. Number of Full..........
46❑ Yes 47�-?k� ' bathrooms Partial........
r
I hereby certify that the ,proposed work is authorized by the owner`of record
and I have been authorized by the owner to make this application as his
authorized agent. _
SIGNATURE'OF 4AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
DEPT. FILE COPY
DEPARTMENT OF BUILDING INSPECTIONS D-
wil _jW 212 MAIN
NO iANPTO
R STREET
A, 01060 BU t LD 1 NG a a
PERMIT VALIDATION
29 ., 456 CODE # 79
December 3,
DATE "'N&Vembei116! 197^ PERMIT NO. 693
APPLICANT Norman PBLEten _- ADDRESS 48 Wildwood bane_ So, Hadlev
..f1 (N0.) (STREET) (CONTR'S LICENSE)
OF
PERMIT TO Residence (_1_} STORY 0130— =711- residence NDWELLING UNITS
(TYPE OF IMPROVEMENT) N0. (PROPOSED USE)
ZONING
AT (LOCATION) Cre4 Aw Dri Ve DISTRICT UR.A.
(N0.) (STREET)
a BETWEEN Off Brookwood Drive AND
m (CROSS STREET) (CROSS STREET)
a
m SUBDIVIS(oN BrOOkWt30f LOT 66 BLOCK SIZE 100 ,Ct-7
V
O BUILDING IS TO BE 24 FT. WIDE BY 42 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION -
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
0:
o REMARKS: See glans for Lot #
/a310od ma--O �
,,p ��� PERMIT
VOLUME 1008 ESTIMAT ST $ 220000 FEE 66.-.-
(CUBIC/SQUARE FEET)
OWNER Norman Paulgpn ;
BUILDING EPT
ADDRESS 48 Wildwnnd_T.mp- Sn. Nadley_t MA. BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)