35-173 (2) ZONING •
SIDE YARD SIDE YARD
REAR YARD
IX. SITE OR •
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IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
owner Or -
Lessee
Builder's
2. .O 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 application as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signatu of i Address Application date
G
0 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number B Permit or Approval Check Dote Number B
Obtained y Pp Obtained 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
II. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued 19 _
Building / r Fire Grading
Permit Fee $ LJYr Live Loading
Certificate of Occupancy $ Occupancy Load
Appro d
Drain Tile $
r�
Plan Review Fee $
�/L1
TITLE
CITY OF NORTHAMPTON
�. .� MASSACHUSETTS
3 OFFICE of the INSPECTOR of BUILDINGS
Page 3a Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
/ �� / ZONING
• AT (LOCATION)�,; L21z s / ' ! d DISTRIC
LOCATION (NO.) (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 ❑ New building Re i ntial Nonresidential
2 Addition(1/ residential, enter number 12 One family 18 ❑ Amusement, recreational
of new housing units added, if any,
in Part D, ]3) 1 Two or more family — Enter 19 ❑ Church, other religious
number of units— — — — -i 20 ❑ Industrial
3 ❑ Alteration (See 2 above) 14 ❑ Transient hotel, motel, 21 L❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 F-] Wrecking (If multifamily residential, of units ——————— — i 22 Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 Hospital, institutional
Part D, 13) 16 Carport
24❑ Office, bank, professional
❑
6 ❑ Moving (relocation)
17 ❑ Other — Speci/y 25 ❑ Public utility
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP 27 L❑ 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................ 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.).............
1
11. TOTAL COST OF IMPROVEMENT $ ❑1
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 VV7 Private (septic tank, etc.) 49. Total square feet of floor area
all floors, based on exterior
32 ❑ Structural steel dimensions ..................... C
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other — Specify 42 X Public or private company 50. Total land area, sq. Ft. ..........
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 IX No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevator? 54. Number of Full..........
-
46 r Yes 47 tkj No bathrooms
Partial.......
i a DEPT. OF BUILDING INSPECTIONS BUILDING �O
212 Main Street !�A 04
Northampton, MA 01060 PERMIT
2 IL
VALIDATION
35 - 173 July 25,
DATE 19 PJrI N 45-� -
APPLICANT Charles E. Kott ADDRESS 13 ur s Pit load I r
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO Addition (_) STORY One Family DNUMBER OF
WELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) 1383 Burts Pit Road DISTRICT
(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
ITYPEI
REMARKS: permit for the addition of a dining room
AREA OR 100 sq. ft. 4,000.00 PERMIT s 16.00
VOLUME ESTIMATED COST $ FEE
(CUBIC/SQUARE FEET)
OWNER Same aC Applicant
Came as Applicant's _—_ BYILDING
ADDRESS ___ �����
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY ^ APPLICANT COPY • Pi SSESSORS COPY pjNT P