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17C-063 (2) Vill ZONING PLAN EXAMINERS NOTES DISTRICT REAR YARD IX. 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IDENTIFICATION — To be completed by all applicants t I rpV,1` Name Mailing address — Number, street, city, and State- ZIP code Tel. No. Owner or "` �� V � ! E Lessee 2. l�Li CJ�jCJy2Tl'I !' f LBcenserNo. 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 oppl' ant Address pp co ion date DO NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Re uired Check Plan Review Date Plans By Date Plans B Notes 4 Fee Started Approved y BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL $ OTHER $ VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Date D Permit or Approval Check obtained Number By Permit or Approval Check Obtta t ed 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 11. VALIDATION Building FOR DEPARTMENT USE ONLY Permit number Building. �__ Use Group Permit issued t E 19i� Building Fire Grading Permit Fee $ � _r_C Live Loading Certificate of Occupancy $ Occupancy Load Appro by: Drain Tile $ L!" Plan Review Fee $ TITLE CITY OF NORTHAMPTON �• MASSACHUSETTS $ OFFICE of the INSPECTOR of BUILDINGS �1 , ,�r Page Plot APPLICATION FOR INSPECTOR ZONING PERMIT AND BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, ll, 111, IV, and IX. O ZONING • AT (LOCATION) ` / `/-te J✓ + ✓' ' DISTRICT LOCATION ((NO.) (STREET) OF BETWEEN � a2� J II AND JT BUILDING ICROSS STREET) (CROSS STREET) QQII ��� LOT /( SUBDIVISION C) LOT BLOCK SIZE N II. TYPE AND COST OF BUILDING — A11 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(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) ��Q _VQV Y�i 14 ❑ Transient hotel, motel, 21 ❑ Parking garage 4 ❑ Repair, replacement or dormitory — Enter number 5 ❑ Wrecking (11 multifamily residential, of units ——————— — --30. 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 — SpeciJy 25 ❑ Public utility 7 ❑J Foundation only 26 ❑ School, library, other educational B. OWNERSHIP 27 ❑J 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 $ 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................ a' 31 F7§ Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area, rlr all floors, based on exterior �ry 32 ❑ �60 Structural steel dimensions ..................... l b 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 ❑ Electricity 44 ❑ Yes 45 X No 53. Number of bedrooms.............. 38 ❑ Coal 39 Other — Specify Will there be an elevator? ❑ p /y 54. Number of Full.......... 46 ❑ Yes 47 ❑ No bathrooms partial........ - w DEPT. OF BUILDING INSPECTIONS z gUIIDING f o j 212 Main Street 0 r l� Northampton, MA 01060 PERMIT 17C - 63 VALIDATION DATE July 2, ___ lg* 85 PE�R7MIy7�IN 374 APPLICANT Jim Cullerny ADDRESS 4 North t., Sheiburn Falls 0326 73 (NO.) (STREET) (CONTR'S LICENSE) PERMIT TO Alteration/Dormer(_) STORY One Family NUMBER NG UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) 169 Chestnut Street ZONING URA 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 for alterations to existing single family dwelling: 34ft dormer and bath AREA OR $ 17 950.00 FEEMIT $ 64.00 VOLUME ESTIMATED COST (CUBIC/SQUARE FEET) OWNER Jim McGuire & Chris Douglas � es nu ., orence, Mass BUILDI '.°; ADDRESS BY WHITE - FILE COPY . GREEN - FIELD COPY w CANARY - APPLICANT COPY • PINK - ASSESSORS COPY PINT P