17D-047 (5) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
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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.
1.
Owner or
Lessee
�je.•--- f �e ,r Builder's
2. � J 6 &7 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 application a s authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signal 7fppcan� Address Application date
Z _ y
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
q Fee Started y Approved y
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
VII. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number 767 of Bui Iding
1`—�-�" IS' Use Group
Permit issued
19 T.3
Building Fire Grading
Permit Fee $ G r�
Live Loading
Certificate of Occupancy $ Occupancy Load
Ap roved by:
Drain Tile
Plan Review Fee
TITLE
4 CITY OF NORTHAMPTON i
MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
,VT Page «D Plot 5�_z APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
7//7 A ° ZONING
I• AT (LOCATION) W✓"�• DISTRICTUA
LOCATION IN 0.) (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
M
1 ❑ New building Reside ial Nonresidential
2 " 1 Addition(If residential, enter number 12 (. One family 18 ❑ Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 ❑ Two or more family — Enter 19 ❑ Church, other religious
number of units— — — — � 20 ❑ Industrial
3 ❑ Alteration (See 2 above) 14 ❑ Transient hotel, motel, 21 Parkin g garage
4 ❑ Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (11 multifamily residential, of units ——————— — -- 22 ❑ Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional
Part D, 16 ❑ Carport 24❑ Office, bank, professional
6 ❑ Moving (relocation) p
7 ❑ Foundation only 17 ❑ Other — Specify 25 Public utility
pa.$4AA 26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
28 ❑ Tanks, towers
8 Private (individual, corporation, Specify
Other — S
nonprofit institution, etc.) 29 ❑ p fy
9 ❑ Public(Federal, State, or
local government)
C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,,,,,,,,,,,,,, school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office building at industrial plant.
To be installed but not included If use of existing building is being changed, enter proposed use.
in the above cost
a. Electrical.....................
b. Plumbing .....................
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT I$ '-
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 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 J Public or private company 50. Total land area, 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........................
36 Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 ❑ Yes 45 ❑ No 53. Number of bedrooms..............
38 ❑ Coal
39 FL_J Other — Speci/y Will there be an elevator? Full..........
54. Number of
46 ❑ Yes 47 ❑J No bathrooms
Partial.......
Depar4men a of Building Inspections
212 Main Street BUILDING Z°
Northampton, Ma. 01060 PERMIT 2a
+� e
17D - 4/ VALIDATION
DATE FPhruarvT5_. —19 93 PERMIT NO. 78
APPLICANT recl, R• JACobS ADDRESS ffR n011j$—AltlmiIIllm _ 03473()
(N0. (STREET) (CONTR'S LICENSE)
NUMBER OF
-- PERMIT TO (_) STORY DWELLING UNITS
SolarE Panels
( E OF IMPROVEMENT) N0. (PROPOSED USE)
ZONING
AT (LOCATION) 74 a'.Yx-w Avenue DISTRICT TTRR
(NO.) (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
(TYPE)
REMARKS:
AREA OR PERMIT
VOLUME ESTIMATED COST FEE
(CUBIC/SQUARE FEET)
a
OWNER Johtt H• Hay dAn
BUIL
ADDRESS 74 StrAW AvQnue, Northampton, Ma. 01060 BY
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY PINK - ASSESSORS COPY