17A-258 (5) � r
ZONING •
FRONT DISTRICT
•
SIDE YARD SIDE YARD
REAR YARD
IX. SITE 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, and State ZIP code Tel. No.
Owner or E14N NT !d3 tK -- 10RE:It�C >f �-39,q-/
Lessee 0 /D(►U
£0,-9
Builder's
2. 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 applicatio as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signal a of applic t - Address�:�Fh,L s1TS_ Application date
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
Permit or Approval Check Date Number By Permit or Approval Check Date Number B
Obtained Obtained 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 310
Building Use Group
Permit issued 19 _
Building � Fire Grading
Permit Fee $ �I ) t
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Z
Plan Review Fee $ 9.
% TITLE
CITY OF NORTHAMPTON
40 MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page l Plot -% APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. 0
I• ZONING
AT (LOCATION) /O3 Ol pp J� A -y'j f:510 100O. C1E DISTRIC t
LOCATION (NO') (STREET)
OF BETWEEN AND
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
1 ❑ New building Residential Nonresidential
2 ❑ Addition(If residential, enter number 12�<One family 18 ❑ Amusement, recreational
of new housing units added, if any, 13 E] Two or more family - Enter 19 ❑ Church, other religious
in Part D, 13)
number of units- - - - -� 20 ❑ Industrial
3 Alteration (See 2 above)
14 Transient hotel, motel,
21 Parking garage
4 Repair, replacement or dormitory - Enter number
22 Service station, repair garage
5 Wrecking (1/mul[iJamily residential, o units --
L�
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 - Specify 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
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,,,,,,,,,,,,,, 35 C/L 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.
in the above cost
a. Electrical.......................
b. Plumbing .......................
c. Heating, air conditioning.......
d. Other (elevator, etc.).............
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 I-)C;_
30❑ Masonry (wall bearing) 40 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. ..........
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET f-)(k
PARKING SPACES
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..........nG.
38 ❑ Coal
39 ❑ Other - Specify Will there be an elevators Full..........
-- 54. Number of
46 r 1 Yes 47 I� No bathrooms
` � Partial.......
DEPT._Or^BUILDING INSPECTIONS zo
212 Main Street
BUILDING 0a
Northampton, MA 01060 PERMIT
17A - 258 VALIDATION
DATE Mau 15 PEERMIT NO. 'iln
� -
APPLICANT Jean Bryant ADDRESS " "a- sT. , Horence uwner
[NO.) (STREET) (CONTR•S LICENSE)
PERMIT TO Alteration/Repair/ReelageTgAA One Family DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
Fl ZONING URB
AT (LOCATION) 103 Oak St. Florence DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREETI
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG 13Y FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: permit for alterations to existing porch area only
AREA OUME ESTIMATED COST $ 3 500.00 PERMIT 10.00
(CUBIC/SQUARE FEET)
OWNER Same as Applicant
BUIL DEPT.
ADDRESS. Same as Aon l i c ant's BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pjNT P