25C-263 (5) Vill. ZONING PLAN EXAMINERS NOTES
FRONT YARD
SIDE YARD SIDE YARD
IX. SITE OR
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP co`ii'2 Tel. No.
Owner or
Lessee
Bui Ider's
2• or 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
-� .��
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B y 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 B Permit or Approval I Chec Date Number B
Obtained y pp Obtained Y
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 FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued 19
Building $ � •��� Fire Grading
Permit Fee
Live Loading
Certificate of Occupancy $ o panty oed
Approved b
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
Page Plots' 3 APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. 0
7 ZONING /Jn
I• AT (LOCATION)
DISTRICT ""
LOCATION (NO.) STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT _BLOCK SIZE
to
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D ;a
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
M
1 ❑ New building Residential Nonresidential
2 El Addition(it residential, enter number 12& One family 18 Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 F--1 Two or more fami ly — Enter 19 Church, other religious
3 Alteration (See 2 above)
number of units— — — — --ii" 20 Industrial
❑
14 � Transient hotel, motel, 21 C� Parking garage
4 Repair, replacement or dormitory — Enter number
5 Wrecking (If multifamily residential, of Units ——————— — -i 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)
17 Other — Speci/y 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,,,,,,•,•....... �Q 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 propop se.
in the above cost
a. Electrical.......................
b. Plumbing ...................... .��4 'd�Of
c. Heating, air conditioning..........
d. Other(elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT 1$ J?m d —.
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 F—] Public or private company 48. Number of stdries................
31 Wood frame 41 F-1 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 C� Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 C Electricity 44 n Yes 45 No 53. Number of bedrooms..............
38 Coal
39 n Other — Specify Will -here be an elevators Full..........
- 54. Number of
46 Yes 47 'D No bathrooms
Partial.......
DEPT. OF BUILDING INSPECTIONS BUILDING "'° i (c)-
! 212 Main Street O`
Northampton, MA 01060 PERMIT <a
25C - 263 VALIDATION
DATE January 17, 19 89 PERMIT NO. 37
APPLICANT Joe BAbal a ADDRESS 17 Old Ferry Rd. Owner
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO OPmnl i t i nng (_) STORY OnP Fami 1 DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSE USE)
ZONING
AT (LOCATION)
17 Old Ferry Road DISTR CT URA(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: nPrml t fnr (iPmn 1 i t i nn S of—PU i S t i ag milk rnn Chickpn hnI ICP, c i 1 n_ Farm 1JSP
never any utility hook-ups
AREA OR ESTIMATED COST $ 300 00 FEEMIT 10.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER Same as Applicant _
ADDRESS ame as pp ican $ ByILL �DL/[tf) ld •
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY PINK - ASSESSORS COPY pjN p