36-144 (4) ZONING •
DISTRICT
IX. SITE 1
•
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NOTES and Data — (For deportment use)
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
1.
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.
Signature of applicant Address Application date
o . �A. y
00 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
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date ate
Permit or Approval Check Obta ned 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
II. VALIDATION
Building l FOR DEPARTMENT USE ONLY
Permit number /o�
Bui(ding. Use Group
Permit issued _ �/ r.+ i 19
Building Fire Groding
Permit Fee $ 47
Live Loading
Certificate of Occupancy $ Occupancy Load
App ed by: j
Drain T i l e � ���.t;Lrt=�-t-c-t1�
Plan Review Fee $ t
w-
TITLE
�oR o CITY OF NORTHAMPTON
�4 '4 _ MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
'"` Page :��6 Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT —// Applicant to complete all items in section/s:: 11, 11, 111, IV, and IX. O
I• AT (LOCATION) DISTR C
LOCATION ^� 5 (STREET
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
V1
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D -i
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
M
1 New building Residential Nonresidential
2 Addition(If residential, enter number 12Nne family 18 Amusement, recreational
of new bousing units added, if any,
in Part D, 13) 13 Two or more family - Enter 19 n Church, other religious
number of units- - - - --� 20 Industrial
3 Alteration (.See 2 above) 14 Transient hotel, motel,
21 Parking garage
4 n Repair, replacement or dormitory - F.raer number
5 �_ Wrecking (If multifamily residential, of units ------- - -- 22 L Service station, repair garage
enter number of units in building in 15 Garage 23 Hospital, institutional
Part D, 13) 16 Car ort 24 n Office, bank, professional
6 �� Moving (relocation) p
17 Other - Specify 25 � Public utility
7 C-� Foundation only 6 n School, library, other educational
B. OWNERSHIP j 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 ((mil 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.)............
11. TOTAL COST OF IMPROVEMENT Is 3 0 OO
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. TY�E OF SEWAGE DISPOSAL J. DIMENSIONS
30 Masonry (wall bearing) Public or private company 48. Number of stories..............
31 Wood frame 41 [] Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior
32 n Structural steel dimensio ........ ...........
33 j Reinforced concrete H. TYPE OF WATER SUPPLY j
r 50. Total lapfd , sq. ft. .
34 �� Other - Specify 42��ublic or private company """"
43 71 Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed .......................
r-
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..............
38l � Coal
39 Other - Specify Will there be an elevatoro Full.........
54. Number of
46 r ) Yes 47 No bathrooms
�- Partial........
� n-
212�MAIN STREET
DEPARTMENT *JILDING INSPECTIONS BUILDING
NORTHAMPTON, MA. 01060 fa
� � PERMIT a
36 — 144 VALIDATION
DATE_ April 14. 19 81 PERMIT NO. 159
APPLICANT_ass r�-F�6��;�1jQ" ADDRESS 31E� RrpnkciAp Circle- F1n.
(N0.) (STREET) (CONTR'S LICENSE)
NUMBER OF 1
PERMIT TO (_1 STORY Tn-ground Wool DWELLING UNITS
TYPE OF I P VEM
ROENT) N0. (PROPOSED USE)
ZONING URA
AT (LOCATION) 316 Brookside Circle DISTRICT
(N0.) (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: Tnctall 16' X 30' inground swimming pool - -
AREA OR ESTIMATED COST $ 3.000 FEEMIT $ 10.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER j,1,+a C' RnAri Cr1iP7 BUILDIN �.,
ADDRESS 316 Rrookci AP C'i re.1 a F1 nren ce. Ma 01060
er GGG�i�CCC����
r
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY