17C-061 (3) Registered Office: Methven Office:
Deloitte Haskins&Sells, Alford Forest Road,
U P.O. Box 248, P.O. Box 14,
Christchurch,8000 Methven, 8353
nNew Zealand New Zealand
�.. Telephone(03) 797 -010 Telephone (053) 28-529
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Vill. ZONING PLAN EXAMINERS NOTES
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)
st
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, cz.ty, an State Td
I. ��.,uG , l &I
Owner or
Lessee ^
`may
2. NNI///"'
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.
Signatuye of ap Ii nit Address Application date
DO 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 $
OTHER $
VI. 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 j FOR DEPARTMENT USE ONLY
Permit number `
Building
., Use Group
Permit issued 19
Building Fire Grading
Permit Fee $ l�'Od
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
t
Plan Review Fee $
TITLE
4aCITY OF NORTHAMPTON
�. .� MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
Page � 7c- Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. 0
ZONING
I• AT (LOCATION)
D I S T R I C 1K
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
11. TYPE AND COST OF BUILDING — All applicants complete Parts A — D ;0
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use 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)
14 Transient hotel, motel,
4 Repair, replacement 21 Parking Cation
p p or dormitory — Enter number
5 Wrecking (If multi family residential, of units ——————— — —� 22 L� 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
n
6 Moving (relocation) 25 Public utility
17� Other — Speci/y
7 Foundation only � /Ti4.r
! 26 n School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
28 Tanks, towers
8 Private (individual, corporation, D.
nonprofit institution, etc.) /��"%_'"`""1 29 Other — Speci/y
90 Public (Federal, State, or &/ 8t y ! y 1 Lr
local government) f� d ' a
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................ a000 — 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.)............. YY
11. TOTAL COST OF IMPROVEMENT $jV d C)
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 W.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS t/
30❑ Masonry (wall bearing) 40 Public or private company 48. Number of stories............... ! Z.
31 Wood frame 41 LE Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior
32 F_� Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 Other — Specify 42 Public or private company 50. Total land area, sq. 4t. ..........
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........................
conditioning?
36 � Oil L. RESIDENTIAL BUILDINGS ONLY
37 Cf Electricity 44 [—] Yes 45 10 No 53. Number of bedrooms..............
38 Coal
39 Other — Specify Will there be an elevator? Full..........
54. Number of
46 Yes 47 �I N-J No bathrooms
C Partial.......
DEPT. OF BUILDING INSPECTIONS BUILDING oa
+ 212 Main Street f
Northampton, MA 01060 PERMIT
17C - 61 VALIDATION
DATE Apri l 20, )g 87 PERMIT NO. 195
APPLICANT John D. Collins ADDRESS 181 Chestnut Street Owner
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO
Addition One Family DWELLING UNITS
1_I STORY
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
181 XX9XXXX Chestnut Street ZONING URA
AT (LOCATION) DISTRICT
1N0.1 (STREETI
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 the addition to living room 4' X 13' _
AREA OR 52 sq. ft. 2,000•00 PERMIT 1 0.00
VOLUME ESTIMATED COST $ FEE $
(CUBIC/SQUARE FEET)
Same as Applicaet
OWNER BU I L
ADDRESS BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY ^ APPLICANT COPY • PINK ASSESSORS COPY poINT SNP