17A-252 (2) For ALL buildings within mire District and for other buildings coating $10,000.00 or more, plans
and specifications must be submitted to the Inspector of Buildings for examination and approval.
If building is tso be moved give details relative to proposed location as for a new building.
Applicatilon for Permit to Build
Northampton, Mass., .vr:_R..S._.......
To the Inspector of Buildings:--
The undersigned hereby applies for a permit to build, move, alter, or repair, according to the
following specifications.— 4!
1. Owner's name .....__.... ................................._.........._._....
2. Owner's address ._....,_..I»�._ ....�-. K E........�.......... ....../ :....._.._...._
3. Architect's name ........................................»._...................................................................
_
4. Builder's name .............. ..................................................»................ »....�
5. Builder's address ...............1.f.x..... ........�.!...._........._.....»....._......._. ._.... .._.w. __.. ._.... _....._ . »
6. Location of Building. Street No. »...._»..»...»...». ........._.»............................_........._._.
7. Is this a removal or new building .........l.-1 ..._......._.........._. ...»
8. If removal, from where .........»................»_.............._.............................................._._...._...._................_.._»
9: What is the purpose of building ..............5..%. ?Qt1.ei t.......'.4JE A...................._........................»..........
....»»»»» . ».
10. Material of building .......»..............f�.S'.�'..!?._............................._......................_.............»............................_............ ..». »
11. If a dwelling, for how many families ....................................._.....Number of rooms .......................»».. »» »... ....
12. Is there to be a store in the building ...._....»...................................».............._».».»» ..._..... ..»» ..».»».».»»»» . .. ....
13. Size of building, No. of feet front .._» » . ..._;NO. of feet deep . _». ».; No. of stories. ..»... ..
14. Size of ell, No. of feet front ......................: No. of feet deep ..................».»; No. of feet high .».» ..»
15. Size of Lot .....»................_........................._................................Feet Wide ........ _ Feet Deep ... _ ». ....»
16. How near tl,e-lire of street .............. ....`.:°......... .,..._.....,....»............................_......... _ .»......._... »_..... » .»»»»». .....».
17. How near the line adjoining lot. Right............................_.....; Left......................_..........; Rear .......:. .F«..r
18. Nearest building is ................................feet in a.................................................... direction .....»........................... »....»»
19. Material of the floor..............D.A.&r..........................................................
»... _.». _.».......». .» ....... ..»»..». »_....
20. Size of timbers, 1st ...................... ; 2nd ....._................ ; 3rd .......................: 4th .................».........
21. No. of feet span ..........._......._...._......................_...._...._....... ; Distance on centers . .._ ..»_.. .... .._ ..».».. . .. »»
22. Will the building be erected on solid or filled land ....._.....F1 p........ ........_....................,....»
23. What is the material of foundation .........». Footing t A`H
24. Will the roof be flat or pitched ...........»..........L.:r WIi .�.........».....; Covering
25. Heat; steam, hot water, furnace, stoves.......................................; Power oil burner ...........................
_ ._.....
2G. Fireplace ...................._..................................................; Insulation ....................................................................... _..._..__..._...._.
27. Hour many sinks ...........; Toilets ............; Lavatories .........; Bathtubs-...-..; Showers...........; Settubs .........
28. City Service.,° Water ..........._........... Sewer ...; Road Surface ,
..................... .............._...........• Sidewalk ..................»....
29. Is lot on j; ;i street ............................................... ....................................»....................................._............._....._.. _ .._......_
..I...p...............................
30. aKima+;�;��Z ;� (raust be filled out) ...................... � ................................._.............................._.
A.p p!icar :y to give d1le, -,-izpector of Buildings 24 hours' notice before lathing or
plaaterin,~ ihis buildin.g. This building will conform to the requirements of the Iaw.
Signatureo;. <.xpy: ic.i it ..._...........�u .��Q ....i� ............................_....»............._........................................_...._._..........I.........
REMARKS
l
1
Tn accordance with Article XI of the Toni*::� Cmlinance, qn for a .
?oniry Pornit muat -include a Plot Plan. The follo-ring characteristics of the
parcel must be shown,
1. Dimensions of the lot.
2. Locations ;;y3 size or all. buildings.
3. Rverage finished grade of all structures existing and proposed.
4. Use of all buildings existing and proposed.
5. Set Backs as indicated on the enclosed plan.
Abutters ':ane
Lit �.TO.
Lot Ft.
Pie ar Yard
Abuttors Abutters
Name „_ - Name
Lot No. Lot. Pao.
If this is a • Sideyard . House € Sidevard If this is a
corner lot, write corner lot, T.-rite
in the name of the in the name of the
other street. other street.
Set Back
0 0
Lot 60- 5 Ft,
TTry e of Street
Indicate location of garage or accessory buildings with a dashed line.
In:icate location of SE:aer hook-up (l
List all past plans, applications, permits, -.art.aces etc. an.'. correspon-1 J-nr dates that
nave b-en processed by this office.
I Certify that the enclosed appTi c-Ption a^d plot plan '-•ro co''°plete and correct,
S o 1�' C r^-?er Hate
Pa.,,e NTo 17A Lot
ZONING PERMIT _ /7A 2
APPLICATION `r� 11-1) r'°. Lot t
Zoning Ordinnl:ce Sc�ctic:n J.O. "ccc:i-v-`c1: File No. I1:+11 Tile
sner s•..J A 1ic; ;!t
Address Akilres.
Telephone I Telephone-
This section is to bie fillcci wit in c±c(-ordc.nce :i 1,1i tl)e 11T bl.e nf Dim,-,ncion-1 and
Density Re lationc:, (Z.0. A'.'TICLE, VI)
Zoning Itce Lot Front Depth ot1j:-)c' Ilax.Blo. Alin. Op.
District J±rea !;j.dt1) brunt S1de > ,, Cover. Space
P ast };xisn-�- -- 8'2•S 2/Q 2t> /S 3O °�
retell f- Proposed A' n°
Mark the approprirnt.e 1ox to :i.ndicrnte the use of them parcel:
Q Pon-Cmiforming, hc)t ,rid/oz `'tructure. mccify
Pesidc:ntial [N�9 Sinule F.-ni]y Unit. =Vulti-Fa^lily
Q Ditpl_ex Q0thei
[� Business
Q Industrial
Q Institute or- 1
[� Subdivision Q Re�;u .I?•A.
O cl.�,r.tr ;, thcr
Q Subdi.visini) with "Apr:r:)v
= Planning ?'o<ord Approv,.l :
= Zonine Board Approval (Special Permit 10. Vari:lnce)
= City Council (Spocinl Fxccption S. 10.101
Watershed Protection District Overls.y: (Z.(`. Sect. .::IV)_ = Yes O A'o
Parkin; Space Reduiremento: (7,.('. ,>ect. X0'.1) Required Proposed
Loading Space Requirement;: (Z.0 "ect. 8.2) Requirc-d Proposed
Suns: (Z.O. Art. VII)
Q Ye:; IIo
Environmental Perforlaanc(-) "tandnrclr: (Z.01 -Art. XI.I) _QYes _�Qr1o_
__ 1
Plot Plan Yes ro Site Plan Q Yes ca'ro
(S. 10..2) (;;. 10. 2, and 10.17
'.Y::iver Grante;l; D,ite
This Faction for OFFICIAL, use on13.: 112EF E S; TAM 0<K b A-"k. IR/-,0 ►
Approval ns p.re sentcd: _
=Hodificati.ons nece:;cary for c�phrov.-)l: -
C]Return: (Ilore information ne ti( ed) � E —
[] Denial: Rerirons:
Signature of Ap;licant. Date )f A(Imill. Officer Hate
I hereby certify that the proposed work is authorized.-b r the- owm.r -of record
and I have been authorized by the ,ownei fo :make th'r xpfacdion os;hls:
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) `(STREET) - ;_(CITY) _
APPROVED BY TITLE
DATE 19
DEPT. FILE COPY
/! Z O
City of Northampton BUILDING VL
Massachusetts PERMIT
Office of the Inspector of Buildings VALIDATION
DATE V 1 197 fo PERMIT NO. 7166
APPLICANTb�ALA ADDRESS 118
(NO.) (STREET) (CONTR'S LICENSE)
/air'X. I'�C-A�, NUMBER OF
PERMIT TO STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. ''�. (PROPOSED jUSE)
AT (LOCATION) I_AYCI= 7-�C�Z`P �'�' / •A-S Y, ZONING
DISTRICT
(NO.) (STREET)
rn BETWEEN AND
'o (CROSS STREET) (CROSS STREET)
rn
LOT
a. SUBDIVISION LOT BLOCK SIZE
T
a (
U BUILDING IS TO BE FT. WIDE BY�_FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
M
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
f (TYPE)
Q:
O
U_ REMARKS:
AREA OR VOLUME 9� ESTIMATED COST $ /70,0 FEEMI
SQUARE FEET)
OWNER NLQL. �t-4
BUILDIN
ADDRESS �_L�3 ' — "` �C �$�` BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)