17A-225 (2) Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
1
FRONT YARD MAWK
SIDE YARD SIDE YARD
REAR YARD
IX. SITE OR PLOT PLAN For Applicant Use
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NOTES and Data — (For department use)
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IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
I. ,•.�Q, i S v-- t �`l 13Z7
Owner Or �
Lessee
�,�1^e.�-.tom v�✓1 � CJ I G Ei c-3
j e Builder's /
2. Qf"/ Q- v, aef;,60 12— �) 12� J t License No. 5y�5py
Contractor 7
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.
Signotugr of applicant Address Application date
z i be K� %AY, - 1=�1� , h'fq . 2 s/�/��
D0 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re uired Check Plan Review Date Plans B Date Plans B Notes
9 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date D
Permit or Approval Check Obtained Number By Permit or Approval Check Obta 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 < cam^ Use Group
Permit issued ' > • 19
Building , Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by: 7
Drain Tile $
Plan Review Fee $ ^
— TIT
CITY OF NORTHAMPTON
�. MASSACHUSETTS
$ d OFFICE of the INSPECTOR of BUI IN S
V T
Page — Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
//J
X21 4 ��� S �� ZONING
AT (LOCATION) J DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
V1
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 ❑ New building Residential Nonresidential
2 Addition(1/residential, enter number 12 One family 18 L❑ Amusement, recreational
of new housing units added, if any, 13 ❑❑ Two or more family — Enter 19 L❑ Church, other religious
in Pa D, number of units >— — — — -
3 ❑ Alteration (SSee e 2 above) 20 ❑ Industrial
14 ❑ Transient hotel, motel, 21 Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (If multi family 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 El Office, bank, professional
6 ❑ Moving (relocation)
17 ❑ Other — Speci/y 25 ❑ Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 Private (individual, corporation, 28 ❑ Tanks, towers
lll"< 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
dep rtment store, rental office building, office building at industrial plant.
7'o be installed but not included I of existing building is being changed, enter proposed use
in the above cost
a. Electrical..................... I]qzs"R�
b. Plumbing ......................
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $ro Ste'
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 4] 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. ... ....... `f J e7
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES f
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 No 53. Number of bedrooms..............
38 Coal
39 ❑ Other — Specify Will there be an elevators �in Full..........
�� 54. Nber of
46 [_� Yes 47 '� No bathrooms
Partial.......
a DEO. OF BUILDING INSPECTIONS BUILDING z°- 6)690/ ND
• 212 Main Street Oa
Northampton, MA 01060 PERMIT
17A - 225 VALIDATION
DATE April 5 T 19 89 PERMIT NO. 203
APPLICANT lvn u l __ ADDRESS 121 i akp St._ Owner
To (NO.) (STREET) (CONTR'S LICENSE)
Addition One Family NUMBER OF
PERMIT TO (_1 STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
1 1
lake Street ZONING URB
AT (LOCATION) DISTRICT
(N0.) (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
'+ + IrrrE)
REMARKS: J]f�p;i+ f� o,h,@- i-b� an abtacC Qd g;;r'^?7p with living rnnm and hathroom RmXxgR
AREA OR 900 sq. ft. for addition 336 gaPIWATED COST $ 65,500.00 FEEMIT bp 264 .00
VOLUME
(CUBIC/SQUARE FEET)
OWNER Same as Applicant
Same as Applicant' s BOIL
ADDRESS BY
WHITE — FILE COPY . GREEN — FIELD COPY • CANARY - APPLICANT COPY ■ PINK - ASSESSORS COPY pop