36-191 (3) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
IX. SITE OR PLOT PLAN For Applicant Use
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IV. IDENTIFICATION To be completed by all applicants
Name Mailing address Number, street, city, and State ZIP code Tel. No.
V
owner or
Lessee
Builder's
License No.. C, ,,e"7/,'
Contra -
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
J�
D0 NOT W R I T E BELOW T H I S L I N E
V. PLAN REVIEW RECORD For office use
Plans Review Required Check Plan Review Date Plans By Date Plans B Notes
Fee Started Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL
OTHER $
V1. 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 I I OTHER
VII. VALIDATION
Building q? FOR DEPARTMENT USE ONLY
Permit number
Bui Iding ry Use Group
Permit issued 19 P0
Bui Iding Fire Grading
Permit Fee Live 'Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�• MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
1Y T
Page Plot ► APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, I1, lll, IV, and IX. ��/ O
1 ZONING
I• AT (LOCATION) t�' � /
� 7 ,1` .� !z . .�.� DISTRIG
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 D New building Residential Nonresidential
2E] Addition(If residential, enter number 12 One family 18 Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 Two or more family — Enter 19 Church, other religious
number of units— — — — —> 20 n Industrial
3 Alteration (See 2 above)
14 Transient hotel, motel, 21 C Parking garage
4 Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (1l multifamily residential, of units ——————— — -i 22 �� Service station, repair garage
enter number of units in building in 15 n Garage 23 n Hospital, institutional
Part D, 13)
16 Carport 24 Office, bank, professional
6 El Moving (relocation) 25 � Public utility
17 Other — Specify
7 Foundation only
26 School, library, other educational
B. OWNERSHIP 27 n Stores, mercantile
8 Private (individual, corporation, 28 n 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 4 `` �/
a. Electrical..................... (. u j
b. Plumbing .....................
c. Heating, air conditioning........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT is
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 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
34 Other — Specify 42 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 E] Electricity 44 Yes 45 it No
53. Number of bedrooms..............
38 Coal
39 n Other — Specify Will there be an elevotoO Full.... ....
— 54. Number of
46 P Yes 47 D No bathrooms
Partial.......
DEPT. OF BUILDING INSPECTIONS �- , �/6
e 212 Main Street
BUILDING � � (�
Nmrlhampton, MA 01060 PERMIT <a
36 - 191 VALIDATION
DATE Dec. 28, 19 87 PERMIT NO. 849
APPLICANT Jampg M_ Parsons ADDRESS 87 Chesterfield Rd. , Leeds 038786
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO NUMBER OF
Alteration (_) STORY One Family DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED US ) C
AT (LOCATION) ur S 1 oa ZONING C T 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: pQpMjtf-er altera:tJQpS to-QXisting sparQ tn r reatP- famijg rnnm_ nnP hpdroom, one bath
existing laundry room
AREA OR VOLUME 800 Sq. ft. ESTIMATED COST � 13,000.00 FEEMIT 82.20
(CUBIC/SQUARE FEET)
Stephen Callahan
OWNER BUILD(
ADDRESS 824 Burts Pit Road BY wpw-,19.
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pINT"P
IMP Q RTA i' MESSAGE
TO
A.M.
DATE IME Pm.
WjiILE YOU WERE OUT
M
OF
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Operator
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