35-119 (3) ZONING EXAMINERS-NOTES
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
IX. SITE OR PLOT
...................... .....
.•NN NrINHlHN•::=;■;1111::::::;::::;;::;:::=:::i:�::i i�i-;;;:; -:;;;;:;;;;i ;;i;;G;;:;':;:w:::;::::_:::::::::::n:::::::::::::::::::::::::::::::.....
na=NatueuNU11rr311:N.•..=■uri.or•■riHNa.aui■:•ir.irS• o.rr �i•e�r•eeHN H.HN fN.NUUnr .•NNrurouuuoHOa.u..HHH.N■.HHO.■1010 is:i:1111: ::::::n11 /•HN uuoauz.. n■N. r• N./•• ■=a. • N ■. • I1i■•��L�Hills/+�i:i::=:a:if::isii:isisii:i.�iiii:::iiiiiii:
Is! is°.ii:i::iiiiiiii:iii
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4111111
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: .i . Rli..irrNNII: ■N.NZ.■.■H!r/.Z/H Hr.N.HN■Hi■.iH Ntn.
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i • • e r ■ • :sss � i s NrNra�:a aaaii iiiiiiaa aa.N==.r•o=•anN.:U■NN.NN.O•i■!/.a/ria.HUNNH.rar N
• .f•.N •nn • r.nNR.I■■■NnlNH.Y7H.Ni.HNlOH.nH.■
r� • aHHrfN.l■.NHNHN•i■NHN/a.rN..nnNNNHHNNN.N.
as a
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as "owes
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iiiii • �_ �_ :�a::ia=i7iti a1� iC:aaNNHa■1/H■Nn•innNNH�ooun=uaa•H•nnN•:ra.N
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a N. N.M f/ .11rtr/N►1NN:.�r.\\. A. n�NN•r.iiNr 1.1�..f�•Ilr.■r■N■r■n•.ni.nl.H■I• .N Nn.Nn■NirNa.a•■ni!•
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a 31!■R•*.�i :••• = r.r• seen • /iL•::.a:�s..r.=.f.i.......:,a■� ........�.a.r.a.,..■■•rlara.N.■R..■L•Np 111...............................
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:� ai•�
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liea .N �. ■a/i- ♦N:HNNON/.N.•.■•■Oan■•N.•Ha0
: pii.: iii;:ii;iiiiiuiiiir;i:;;;;Li;;�i•HLn;LLi:Giiilril ru�HN•td!■■.Hl■rl•H■...1■/■moves■!a.//.N.HrN.
' la a N ssne.�sat=ssassse1ee ssseas=i�Hm�00ss =sse i ; eE e=se's e��a�i111E ::un u e 's s°a
N ■: u. H.r e■ we NNNUs:N NSr.... .aiGrl n■..■a.iiauna:N.NO:uNNNN.n•uHN■N■NaoaNN11r
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: a sseseasN..11• seep i s s s a : a■■•= ••••••••■assessls.l.■s••
i� • •� � �eua • N.. Nuu■ N u.HH• N■na.H • aurHNU.N.f• NwuNN.NH u• Nuairn■N■..nuou uuu
l: s: : . • i:a i:, 11'11: ii:!': aaaa:iai:::•aia11i:::ais:a::000 :a:a::aii::::as:sa:aasaisis:::•a:
! � i e e;=eu'a`� eee es�.3 r......_ ..e'a s'as:ss...� .aa:a.i....me' 11"a�a:::s 1111.°1111.°::::_::::::::::::�:::::
t NNtH iar tr • • •.a ■.l ■ ptN• Nr N. •N.NNrH •!N.•■r.N. nn■.
N 1' a�aa H I •. s.....NN...aa.: .:■rH a:iiN:a::ess:s::s/a :�■ • rHN •aNNH..NNra.araN.
.. . ai; „ .. .. ..::s.=... • a .....:s..:•:••aa:=j•s::•ss a ..:.111:111. .................i..;�.
.. . ..• i . . ..............•....... .. .
r ' ' : :aN■�iiii � i i1119■rriii•iNa ja�n■i■ = iiia11ti �ar•NmN.nuNNNaNa■"r
• 1 fa i.nu u.■ • •n • H ■ uu� • H/N•/ ■f■N■.N 88UHHn.HNHH..iN.r• s,
• r i. • is Et a is :::: s•• ■I!- a- ■oN H u nu.u•oNUUN.■ as
:: �' i :ii::■•■ r ii i= a'•ate:• ''■iia:iiii::r••a■■.■.tl..•a.■i■■Nr
11411 ri 0•.. 110 ■.•. • •• ia'�t ..ati'aiBIN i........N..�.:•SOman
a.1 :a : s: l :l. /.a RH/ N.H/..Hla • • nt
i! . • Ol • N NIH..bN NN N/ NNt7 ••N•.N■HHn■Nn.N.Nn r•.O 1
i .� ::aeease Site e: a i iaa ai .z .eieelip ialaasi:=i:iaa:'aa:: inn"a:a?1
: . ...s eessi s isa=• 3.: s s a_�raas s as as :Ina::::sa::: ��.:_ _Ns=:;
►, ia, 1111: �i•/� ¢ ■ r�s■:•,iaa ■ !■ r�ia•a �'j•�i�1.Na•a N/NNODUOn •a7 • n
i �Li::aaZ F ii�ii ii'i �ia•iN.i.�.•/r. 1111■aZ :1111 apa:l
•a■l. arrNia a■
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01 is
some r:1111:=1111:;::
I'
NOTES and Data — (For department use)
•
. � s
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
I
Owner or � !4-3
Lessee
�����+� Builder's
2. "�J �� License No.
Contractor p1t�
3.
Architect or 0,116�
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.
Signature of applicant Address Application date
tog
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 Is
OTHER Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number B Permit or Approval Check Date Number B
Obtained y PP Ob}girted y
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 . ` Use Group
Permit issued �Q "�_ 19 0
Building Fire Grading
Permit Fee $ _ �a�
Live Loading
Certificate of Occupancy $ Occupancy Load
$ AppLoy
Drain Tile
J
Plan Review Fee
GL
TIT
CITY OF NORTHAMPTON
MASSACHUSETTS
$ e OFFICE of the INSPECTOR of BUIL INGS
T Page ' -Plot` ! P'PL''ICATION FOR
INSPECTOR t. 'ZOIVI'NG'- 'PERMIT AND
B,UILDING PERMIT
Z
''� °• ` IMPORT�AX}NT�)- Applicant to completed 7al�l items in sections: 1, 11, 111, IV, andlX. O
I• (LOCATION) 1 / JC..Iy`� UC DINING
AT
DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN �IAUA�46 AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
Ii. TAPE AND`EOST OF BUICDING' – -all applicants comple-te 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 12g 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 Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (Il 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 l � Office, bank, professional
6 ❑ Moving (relocation)
17 1— Other — Specify 25 ❑ Public utility
7 �� Foundation only
26 School, library, other educational
B. OWNERSHIP 27l Stores, mercantile
8� Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 Other — Specify
9 D Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food
S146t-1-oAv-f processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,,,,,,,,,,,,,, C1t9 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 ....................... 11
It
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 .Number of stories.�7�!0.......
30 �❑ Masonry (wall bearing) 40X Public or private company
31 Wood frame 41 [—] Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based an exterior
32 ❑ Structural steel dimensions .G.................4
33 �❑ Reinforced concrete H. TYPE OF WATER SUPPLY
'W C W' pm-
-- 50. Total land area, sq. ft. ...
34 � _� Other — Speci{}
42 � � Public or private company
43 Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 Gas `�J`+� Will there be central air 52. Outdoors........................
36 Oil 4SKI-!5lrnM4q L. RESIDENTIAL BUILDINGS ONLY
37 E] Electricity 44 Yes 45KNc
53. Number of bedrooms—�r.........
38 Ll Coal NO G{j4KC
39 Other — Specify Will there be an elevators Full..........
54. Number of
46 Yes 471�< No bathrooms
Partial.......
CL
W p CrJ
TQ CA
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