36-193 (2) ZONING
DISTRICT
USE
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SIDE YARD SIDE YARD
REAR YARD
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and .State ZIP code Tel. No.
- z � i�v` o �Id�c� lzt
Owner or
Lessee
Builder's
2. 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.
Signasure of ap lica t Address Application date
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 By Permit or Approval Chec Date Number B
Obtained 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. r Use Group
Permit issued (L J. 1' 19
Building Fire Grading
Permit Fee $ Live Loading
Certificate of Occupancy $ Occupancy Load
$ Approved by: ;��!�/l j� ,,�,
Drain Tile _ ...r_,,4
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
ge .� MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
t Page `' Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING
AT (LOCATION) `-' ~-r.1�L°«� S �" ( �� D STR CTS'
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vr
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
1 ❑ New building Residential Nonresidential
2"Ftj Addition(I/residential, enter number 12❑ One family 18 ❑ Amusement, recreational
of new fiou3 units added, i/any,
i 13 F-1 Two or more family - Enter 19 ❑ Church, other religious
Part D, 1 number o/units- - - - --
3 ❑ Alteration (See e 2 above) > 20❑ Industrial
14 ❑ Transient hotel, motel, 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory - Enter number
5 ❑ Wrecking (11 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 Carport 24❑ Office, book, professional
6 ❑ Moving (relocation)
17❑ Other - Specify 25❑ Public utility
7 ❑ Foundation only
_ 26 ❑ School, library, other educational
B. OWNERSHIP `� 27❑ Stores, mercantile
8'K 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,,,,,,,,,,,,,,,, 1 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.....................
1,
b. Plumbing .....................
c. Heating, air conditioning........
d. Other (elevator, etc.).............
"-T
11. TOTAL COST OF IMPROVEMENT $
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 1V.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS I
30❑ Masonry (wall bearing) 40 ❑ Public or private company 48• Number of stories...............
3� Wood Frame 41 ❑ 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 r
34 ❑ Other - Specify 42 ❑ 50. Total land area, sq. ft. ...Public or private company """" ale_,�
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........................
conditioning?
36 ❑ Oil L. RESIDENTIAL BUILDINGS ONLY
'NS 377 Electricity 44 ❑ Yes 45 No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other - Specify Will there be an elevator? Full..........
54. Number of
46 ❑ Yes 4� No bathrooms
Partial.......
DEPT. bF BUILDING INSPECTIONS
BUILDING z�
212 Main Street
Northampton, MA 01060 PERMIT <a
36 - 193 VALIDATION
DATE September 25 85y MIT NO. 565
�
APPLICANT Theodore XM Towne ADDRESS f L1CL St File
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO Addition (_) STORY Family Room NUMBERNG OF
UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE) c
AT (LOCATION) 798 Burts it . ZONING CT SR
(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 the construction of a addition of a family room on side of existing
we ingq,
AREA OR 1 `� �'S ft. 201000.00 PERMIT 80.00
VOLUME ESTIMATED COST $ FEE
(CUBIC/SQUARE FEET)
OWNER Dante F. Perozzi
798 Burts Pit Road BUILDING
ADDRESS BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY - PINK - ASSES ORS COPY p'INT IIP