17C-079 (2) Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT
SIDE YARD SIDE YARD
REAR 1
IX. SITE OR PLOT PLAN For Applicant
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Nome Mailing address — Number, street, city, and State ZIP code Tel. No.
1.
`'
Owner or /�f9V-C 4l R 3rr ) A/!r f1 /4; 55 J'O Y-
It
Builder's
L.
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.
Sig t re of Qpp�icoot Address � � 0 1060 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
Date Date
Permit or Approval Check Obtained Number By Permit or Approval Check Obtained 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
Permit / —� Fire Grading
Pmi
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
Appr
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�• MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
��C _
t � Page Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT - Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
.+ _ ZONING
• AT (LOCATION) ( ki �7 ,//.'-e E' �` DISTRICT
LOCATION (N0.) r (STREET)
OF BETWEEN J�3t't r`�I=e V AND t,r� f'• ,1 � t_,� .. �x f
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 m
M
1 ❑ ew 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 L❑ Industrial
3 ❑ Alteration (See 2 above) 14 Transient hotel, motel,
21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (11 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)
7 ❑ Foundation only 17❑ Other — Specify 25 ❑ Public utility
26 ❑ School, library, other educational
B. OWNE HIP 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,,,,,,,,,,,,,,,, ®d school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office building at industrial plant.
7'o be installed but not included If use of existing building is being changed, enter proposed use.
in the above cost O l
a. Electrical..................... L vti /
b. Plumbing ........ —,'
c. Heating, air conditioning......... .`c
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT Is
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. PRINCIP L TYPE OF FRAME G. TYPE OF—SEWAGE DISPOSAL J. DIMENSIONS
30 onry (wall bearing) 40 ZPublic of.pri-vote 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 ..................... 96
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY "
34 ❑ Other — Specify 42 Public oa=ptrwote company 50. Total land area, sq. ft. ........... 96 S�
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINL 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 N"I No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevator? ,. Full..........
54. Number of
46 [-1 Yes 47 No bathrooms Partial.......
Department of Building Inspections
212 Main Street - .., I
Northampton, Mass. 01060 BUILDING o°
17C - 79 PERMIT j<
VALIDATION
DATE July 16, tg 84 PERMIT NO. 306
APPLICANT Havelock Purseglove III ADDRESS 37 High St.,L Florence Owner
(NO.) (STREET) (CONTR'S LICENSEI
Addition Utility Room NUMBER OF
PERMIT TO (�) STORY DWELLING UNITS _
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
37 High Street Florence ZONING LM
AT (LOCATION) ! DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Addition 12 8
O
WDSMIS 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 to build an addition onto the rear of existing home, addition will equal off
the house with the bathroom on the left side and new utility room on the right. Also
will be building a cellar made of cement block under the new addition.
VOLUME 96 sq. ft. ESTIMATED COST 2,000.00 FEEMIT s 10.00
(CUBIC/SQUARE FEET)
OWNER Havelock & Frances Purseglove III
ADDRESS lg
Street, roence, ass. BU T
BY
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