28-033 (5) Vill. ZONING PLAN EXAMINERS NOTES
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SIDE YARD SIDE 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 ZIFAcode Tel. No.
C a
Owner or �r
Lessee
Builder's
1• em c AS1 C (2j,ti ST License No.
Contractor r
r
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
IJ-t -4 l/\,YY\.S S.� (� C ,r\iL- if 12 7 l Igo
D0 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 Is
OTHER $
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check
Date Number B Permit or Approval Check Date Number B
Obtained Y pp 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
VII. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued 1 1 \���1 i( � 19 A
Building 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
t
Page Plot j3 / APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. C)
ZONING f
I• AT (LOCATION) DISTRICT
LOCATION (NO.) (STREET)
OF BET1 EN 9(0 ) r�-�v�+ d 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 rn
rn
1 ❑ New building Residential Nonresidential
2 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❑ Industrial
3 ❑ Alteration (See 2 above)
14 ❑ Transient hotel, motel, 21 Parking garage
4 ❑ Repair, replacement or dormitory - Enter number
5 El 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 r Office, bank, professional
6 ❑ Moving (relocation)
17 >< Other - Speci/y `r1 25 Public utility
7 ❑ Foundation only
L���.,,, 26 ❑ School, library, other educational
B. OWNERSHIP �� vn - Y 0 27 Stores, mercantile
8 Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 Other - Specify
9 Public (Federal, State, or a q awn t�Gv
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................ (j 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.)............
1
11. TOTAL COST OF IMPROVEMENT $ ,� 0C U
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) 40X Public or private company 48. Number of stories...............
31 Wood frame 41 El 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 42X Public or private company 50. Total land area, sq. ft. ..........
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
0
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 Electricity 44 Yes 45 No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other - Specify Will there be an elevators Full..........
54. Number of
46 C� Yes 47 No bathrooms Partial........
DEPT. OF BUILDING INSPECTIONS BUILDING Z° qV
! 212 Main Street 0<
Northampton, MA 01060 PERMIT <a
R 28 - 33-29 VALIDATION
D TE 11 9 88 PERMIT NO. 299
APPLICANT
Hoa Truong & THAnh Pam ADDRESS regory I-ne owner
lNO.I (STREET) (CONTR'S LICENSE(
Addition Finish basement NUMBER OF
PERMIT TO ( ) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) DISTRICT iTR A
NO.) (STREET)
BETWEEN AND
(GRQS3 STREET) (GROSS 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: to finish basement for a study room & storage & family room.
AREA OR $ 3.000.00 FEEMIT 20.90
VOLUME ESTIMATED COST
(CUBIC/SQUARE FEET)
OWNER Hon T Truong & Thanh Ph am BUILD( E Q
ADDRESS 32 Gregor Lane BY— �
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK ^ ASSFrSORI COPY P f P