17A-219 (5) ZONING •
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE l
OR PLOT
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants ""
Name Mailing address — Number, street, city, art,/ State ZIP code Tel. No.
w
Owner c.
Lessee
r LBcens r 's
2. e 1 7 _
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.
Sipature of applicarft A dress Applic ion s e
� i
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plan Review Date Plans Date Plans
Plans Review Required Check Fee Started By Approved BY Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
V1. 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
V11. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building- Use Group
Permit issued 19
Building Fire Grading
Permit Fee $ Z4. 62e
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee
TITLE
CITY OF NORTHAMPTON
9; *>� MASSACHUSETTS
$ y
�` OFFICE of the INSPECTOR of BUILDINGS
'"' Page ��a Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, II, III, IV, and IX. O
ZONING
• AT (LOCATION) 1� t• ( 2 �' � "� DISTRICT J
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(If residential, enter number 12 One family 18 ❑ Amusement, recreational
of neu, bousing units added, if any,
in Part D, 13) 11 ❑ Two or more fomily — 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 (II 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 — SpeciJy 25 ❑ Public utility
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP 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
F -- 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. f
in the above cost
a. Electrical.....................
b. Plumbing .......................
c. Heating, air conditioning.......... /r
d. Other (elevator, etc.)............. i
11. TOTAL COST OF IMPROVEMENT $ .`)
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) _,Public or private company
48. Number of stories..I 1
40G ,r .......
31 Wood Frame 41 ❑ Private (septic tank, etc.) 49. Total square Feet of floor area,
all floors, based��$$n exteri r/
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. PRtlNCIPAL 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 C� Electricity 44 ❑ Yes 45 No 53. Number of bedrooms.............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevator's Full..........
54. Number of
r
46 l ] Yes 47 LYNo bathrooms Partial........
Department of Building-Jrnspections
212 Main Street BUILDING o- �
§ , M
Northampton, Ma., 01060 PERMIT 2IL
ow— a
17A - 219 VALIDATION
DATE July 151, 82 PERMIT NO. 329
APPLICANT Richard W_ VelanP ADDRESS 4 M"TP(
(NO.)16 (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO_A it @.=ati.0� (Z) STORY EXtPT'LAT ct9�r8 DWELLING UNITS 1 —.
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT AT (LOCATION) yy4 NQ� Manle _-- DISTRICT URB
(NO.) (STREET
BETWEEN AND
(CROSS STREET) (f.R055 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: Add Axtiorlow vabac all.-Ira
AREA OR PERMIT
VOLUME ESTIMATED COST $ 37500 FEE 10 0.0
(CUBIC/SQUARE FEET) /f
OWNER i!i 4C and W- Vonnip
1060 BOIL ING D PT.
ADDRESS 164 �-r F
WHITE - FILE COPY - GREEN - FIELD COPY - CANARY - APPLICANT C`6-P-Y-- PINK - ASSESSORS COPY