17A-097 (5) r �
ZONING •
DISTRICT L)
USE
FRONT YARD
SIDE YARD SIDE YARD
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REAR YARD
IX. SITE i
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NOTES and Data — (For department use)
7
l
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing addr ss — Number, strut, city, and State.. ZIP code Tel. No.
Owner or �� /✓ G'
Lessee 11,10r2 7f/.9111/" 7-"'
Builder's
2. D License No.
Contractor Glz?
rx
y �=
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 a razed agent and we agree to conform to all applicable laws of this jurisdiction.
Signatur a plican Address Application date
t� 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 $
OTHER
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date D
Permit or Approval Check Obtai ed 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
VII. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building. Use Group
Permit issued 19�
Building Fire Grading
Permit Fee
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
r
Plan Review Fee
TLE
CITY OF NORTHAMPTON
�• �:� MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
Page Plot 9 7 APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
�J ' ,r ZONING
I• AT (LOCATION) / Q n v . r DISTRICT
LOCATION IN 0.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D -i
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
M
1 ❑ New building Re d ti" Nonresidential
2 ❑ Addition(If residential, enter number 12(Kne family 18 ❑ Amusement, recreational
of new housing units added, if any, T
in Part D, 13) 13 ❑ Two or more family — Enter 19 ❑ Church, other religious
number of units— — — — ---)- 20 ❑ Industrial
Alteration (See 2 above) 14 Transient hotel, motel,
21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (It 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) p
7 ❑ Foundation only 17❑ 0 er Specify 25 ❑ Public utility
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8 Private (individual, corporation,
28 ❑ Tanks, towers
nonprofit institution,etc.) L' 29 ❑ Other — Speci/y
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,
f 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
a. Electrical..................... 155
b. Plumbing .....................
c. Heating, air conditioning..........
d. Other (elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT 1$ c>GG
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 Number of stories...�..........
31 y�l Wood frame 41 ❑ Private (septic tank, etc.) 49• Total square feet of floor a ,�
�'—t all floors, based o xterior
32 ❑ Structural steel dimensions .....
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34E] Other — Specify 42 Public or private company
50. Total land orea, 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........ ..........
3D<10i I conditioning?
L. RESIDENTIAL BUILDIN61 NLY
37 Electricity 45No
u y �- 5�44 Yes - 53. Number of bedrooms....-r........
38 ❑ Coal /
39 Other — Specify Will there be an elevators Full..
54. Number of
46 Yes 47_N N0 bathrooms /
Partial.. ...
4
Dez)art:eert of Bullclaln'-- Tnsprctions
2121 'laip Strcct
Nortb;aip ton, " ass. 0106r BUILDING
O<
�aL
PERMIT 4 a /Dt �)�:)
1 97 VALIDATION
DATE
c TijA P 19
, -3
PER M IT
NO. =` iiael Sh�nn or , -(7 Ay S t r e e,t 2
OC J tz 7
APPLICANT ADDRESS
,
(NO.) (STREET) (CONTR'S LICENSE)
'L i or One Fa— 1,17 NUMBER OF
PERMIT TO STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
37 Terrace ZONING
AT (LOCATION) DISTRICT____:L.
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK-SIZE
BUILDING IS TO BE FT. WIDE BY 19 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: per:'!l.t to convcrt `'ara ,'c to a root ., rii:d --inelows, waoe- stove and chi( rey,
raise ccilip- and add sissors truss, ins-talate walls with 3=� Flber olass
AREA OR PER MIT
VOLUME 266 sQ. ft. ESTIMATED COST $ 2.or)o-'r FEE
(CUBIC/SQUARE FEET)
'L'at & Eileen fl VS
OWNER Urancv-Lew 'rcrracc BUILDIN 40E .
ADDRESS BY
WHITE FILE COPY m GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK ASSESSORS COPY