25C-020 ZONING •
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
IX. SITE OR PLOT PLAN For Applicant Use
•-----------------------------................ ----
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants _
Name Mailing address — Number, strut, city, and State ZIP code Tel. No.
1.
Owner or
Lessee1
Builder's
2. /". /0407 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 authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signat ot appli
t t / Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
9 Fee Started y Approved y
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 a� FOR DEPARTMENT USE ONLY
Permit number n
Building- Use Group
Permit issued 19
Building Fire Grading
Permit Fee
Live Loading
Certificate of Occupancy $ Occupancy Load
Ap d by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON Cf
�• �� MASSACHUSETTS
r
$ OFFICE of the INSPECTOR of BUILDINGS
Page 46 C Plot 2 � APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT - Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING
I• AT (LOCATION) �'�" DISTRICT
LOCATION (NO.) (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 -+
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
M
1 ❑ New building Resident' I Nonresidential
2 Addition(If residential, enter number 12 One family 18 ❑ Amusement, recreational
of new bousing units added, if any,
in Part D, 13) 13 ❑ Two or more family — Enter 19❑ Church, other religious
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 (If 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, bank, professional
6 ❑ Moving (relocation) P
17 ❑ 0th r — Specify 25❑ Public utility
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP _ 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 (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.).............
11. TOTAL COST OF IMPROVEMENT is ` G'
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
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed .......................
35 ❑ Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning?
—� L. RESIDENTIAL BUILDINGS ONLY
37 CJ
38 Coal Yes 45 N Electricity 44 ❑ o
-- 53.' Number of bedrooms..............
❑
39 ❑ Other — Specify Will there be an elevator? Full..........
54. Number of
46 ❑ Yes 47 ❑ No bathrooms Partial........
Department of Building Inspections
212 Main Street BUILDING
Northamp ton.% M, . 01060 0<
25C-20 PERMIT /-
VALIDATION
DATE FAhruary 16i-1983 PERMIT NO. 81
APPLICANT raci l $ ,jar.01's ADDRESS R M cis Aluminum _ 030739
INo. (STREET) (CONTR'S LICENSE)
PERMIT TO (_) STORY col ar Pane NUMBER OF
1$ DWELLING UNITS 1
OF 1 ENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) North —DISTRICT �B _
(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:
AREA OR PERMIT
VOLUME ESTIMATED COST $ 5950.00 FEE $ 24_00
(CUBIC/SQUARE FEET)
OWNER LAT= Hoinpvman
BUILDI
ADDRESS 192 Npr h rppt- Northampton, Maw Q1060 BY
v If
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