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17C-058 (5) ZONING • / ► DISTRICT USE FRONT YARD SIDE YARD SIIE YARD Ix. 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ME$ = $$asp°.s.*,g;'gg�=*�ggggg $'S$ggeg sg gg sg ::::: • 1• u!anN\ • - aIM Hr.�lu 1st! ;11113 =� ��eu is :�:=:sees=:::re;::;:_ NOTES and Data — (For department use) 1�� CD.��a-t�t � � -t-.�$�ti� _ � ' Q� � w :� a �� �� c� IV, IDENTIFICATION — To be completed by all applicants Name Mailing address — Number, trret, city, and State ZIP code Tel. No. Owner or /a 6V Lessee Builder's 2. 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 Z-2 7- ,272 00 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 I Is VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Date Permit or Approval Check Obtained Number By Permit or Approval Check ObttaiTned 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 FOR DEPARTMENT USE ONLY Permit number Building Use Group Permit issued 19 Building i Fire Grading Permit Fee Live Loading Certificate of Occupancy $ Occupancy Load lift Approved Drain Tile $ Plan Review Fee $ TITLE CITY OF NORTHAMPTON g. MASSACHUSETTS $ OFFICE of the INSPECTOR of BUILDINGS ur Page L Plot APPLICATION FOR ZONING PERMIT AND INSPECTOR BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: 1, 11, Ill, IV, and IX. 0 ZONING I• AT (LOCATION) 3 t' DISTRIC LOCATION (N .) (STREET) OF BETWEEN AND BUILDING (CROSS STREET) ICROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE (A 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 ) New building 9 Re i entiol 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 ❑ 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 ❑ Office, bank, professional 6 ❑ Moving (relocation) 17 �� Other — Specify 25 L Public utility 7 ❑ Foundation only 26 ❑� School, library, other educational B. OWNERSHIP 27 L� 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 r a. Electrical..................... ' c i b. Plumbing ..................... c. Heating, air conditioning.......... d. Other (elevator, etc.)............. 11. TOTAL COST OF IMPROVEMENT 1$ / 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 F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ....................... 35 ❑ Gas gillth be central air 52. Outdoors........................ :, COnaTil.p n4r1!Q� 36 ❑ Oil L. RESIDENTIAL BUILDINGS ONLY 37 Electricity. "#�„ d4'• r'1ies, - 45 � ! No 53. Number of bedrooms.............. 38 ❑ Coal � ' i 39 ❑ Other — Specify Willthere be an elevatoro Full.......... _ 54. Number of 46 Yes 47 ' No bathrooms Partial....... w � i ,� w DEPT. OF BUILDING INSPECTIONS BUILDING IDZX�) 212 Main Street 0 Northampton, MA 01060 PERMIT 17C - 58 VALIDATION DATE SP�nt.. _�(7� )� e$ nUfPSI�IT NT 621 lorence Owner APPLICANT Edward Hurlburt ADDRESS J� r (NO.) (STREET) (CONTR'S LICENSE) PERMIT TO New Building (_) STORY Storage Shed DWELLRING OF UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) 1 ZONING 90 Chestnut Street UkA AT (LOCATION) DISTRICT (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE 8 FT. WIDE BY 10 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS, permit for the construction of a storage shed AREA OR VOLUME 80 $Q. f t. ESTIMATED COST $ 695.00 PERMIT $ 10.00 (CUBIC/SQUARE FEET) OWNER Same as Applicant BU ADDRESS Same as Apgl icant I s BY WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY ■ PINK/ASSE S SORS COPY P'INTIP