35-144 (2) Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
SIDE YARD SIDE YARD
REAR YARD
OR PLOT PLAN For Applicant Use
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NOTES and Data — (For department use
can
a
s
T V
-
IV. IDENTIFICATION To be completed by a// applicants
Name Mailing address Number, street, citv, and State Z I P code Tel. No.
Owner or 17'
Lessee
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 application as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature of a/�p�i)'ant Address Applicatio
n date
V. PLAN REVIEW RECORD For office use
Plans Review Required Check Plan F Review Date Plans By Date Plans By Notes
ee Started Approved
BUILDING $
PLUMBING $
MECHANICAL 1$
ELECTRICAL $
OTHER $
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obto ined Number By Permit or Approval Checki 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 L)::t:
Building Fire Grading
Permit Fee Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile
Plan Review Fee
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
$ f OFFICE of the INSPECTOR of BUILDINGS
Page Plot N't APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING
I. i ,� ', DIISTR CT
AT (LOCATION)
LOCATION (NO.) (STREET)
OF BETWEEN Ni"r AND
BUILDING (CROSS STREET) ( (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
CA
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
A. TYPE OF IMPROVEME4T; D. PROPOSED USE — For"Wrecking" most recent use m
M
1 i o 'New building Reside fiat Nonresidential
2 Addition(If residential, enter number 12 t One family 18 ❑ Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 ❑ Two or more family – Enter 19 ❑J 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 El Wrecking (If multifamily residential, of units ——————— — -i 22 Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 L❑ 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, 26 ❑ 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,,,,,,,,,,,,,,,, � 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
48. Number of stories................
30❑ Masonry (wall bearing) 40 ❑ Public or private company
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
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 n Yes 45 !— No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevator? 54. Number of Full..........
46 Yes 47 ❑ No bathrooms
Partial......
DEPT. OF BUILDING INSPECTIONS BUILDING z° &x)+ 212 Main Street Oa /
Northampton, MA 01060 PERMIT
35 - 144 VALIDATION
DATE M 19 PERMIT NO.
APPLICANT Joan C. Fox ADDRESS Westw000 Terr. Owner
(NO.) (STREET) 1CONTR•S LICENSE)
New Building (`) STORY Shed NUMBER OF
PERMIT TO DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
21 Westwood Terr. , Florence ZONING SR
AT (LOCATION) 01STRICT
(NO.► (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION O LOT BLOCK SIZE
O
BUILDING IS TO BE FT. WIDE BY 8 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS. permit for the construction of a storage shed
AREA OR 64 sg. ft. ESTIMATED COST $ 169.00 PER FEE $
10.00
VOLUME
(CUBIC/SQUARE FEET) �r.R •
OWNER Ronald & Joan Fox
I&W*ftp
ADDRESS 21 Westwood Terr. , Florence BY
WHITE - FILE COPY . GREEN - FIELD COPY a CANARY - APPLICANT COPY • PINK ^ ASSESSORS COPY p -1 P