25C-097 (3) Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
IX. SITE OR PLOT
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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.
1. _4
Owner or tjez er fli,A
Lessee
of! it
Budder's..
2. —AZ-le"I ;J
IJ License N
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 dote
�e
0 0 NOT W R I T E BELOW T H I S L I N E
V. PLAN REVIEW RECORD For office use
Plan Review Dote Plans Date Plans
Plans Review Required Check Fee Started By Approved By Notes
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 1 FOR DEPARTMENT USE ONLY
Permit number
Building- Use Group
Permit issued L", 19
Building L t Fire Grading
Permit Fee Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $ oil
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
$ e OFFICE of the INSPECTOR of BUILDINGS
Page 5 L- Plot— APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Abpplicant to complete all items in sections: 1, 11, 111, IV, and IX. 0
ZONING
I• AT (LOCATION) 1�3'� IVIQr DISTRICT
LOCATION -' (NO•) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
IL 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 Residential Nonresidential
2 Addition(I/ residential, enter number
12F-1 One family 18 ❑ Amusement, recreational
of new housing units added, if any, 13 F-1 Two or more family - Enter 19 ❑ Church, other religious
in Part D, 13) number o/units- - - - •-!
3 Alteration (See 2 above) 20❑ Industrial
14 ❑ Transient hotel, motel, 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory - Enter number
5 F-1 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 F-] Carport fig,- 24❑ Office, bank, professional
6 ❑ Moving (relocation)
17 ❑ Other - Specify i 25❑ Public utility
7 ❑ Foundation only y`�((tl .t �y( �_F 26❑ School, library, other educational
B. OWNERSHIP 10 I �tL/" 't _ "-�"'-- 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,,•,,,,,,,,,,,,, (l° 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 y
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 ❑ Electricity 44 ❑ Yes 45 I'7 No 53. Number of bedrooms..............
38 ❑ Coal
39❑ Other - .Specify Will there be an elevator? Full..........
54. Number of
46 ❑ Yes 47 ❑ No bathrooms
Partial.......
DEPT.OF 13MI-DING INSPECTIONS Z D /
BUILDING ',
! 212 Main Street O<
Northampton, MA 01060 PERMIT <a
25C - 97 VALIDATION
DATE January 6, 19 86 PERMIT NO. 10
APPLICANT Douglas Courtney ADDRESS Rocky Pt. Rd., Huntington 043277
(NO.) (STREET) (CONTR'S LICENSE)
Alteration Existing Family NUMBER of
PERMIT TO (_) STORY g DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
193 North Street ZONING M
AT (LOCATION) 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
(TYPE)
REMARKS: permit to make attic space additional living_space for occupants already occunyinQ
existing 2 family dwelling. No bathroom or kitchen
AREA OR $ 6,000.00 PERMIT $ 24.00
VOLUME ESTIMATED COST FEE
(CUBIC/SQUARE FEET)
OWNER gqD�Q+7W�Z�Tom MCCurry & Heather McLaughlin
17J LVVLStreet BYIL, �
ADDRESS
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY • PINK - SSESSORS COPY PINT IIP