35-160 (5) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
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BOCA FORM APEBP — 669 C1969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or `" t
Lessee
Builder's
2. rt
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.
Sign ture of applicant Address 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 y Permit or Approval Check Date
PP Obtained er 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
Building /"'�� 19� Use Group
Permit issued ( J
Fire Grading
Building
Permit Fee $ • Live Loading
Occupancy Load
Certificate of Occupancy
A,pp by:
Drain Tile $
Plan Review Fee
TITLE
NOTES and Data — (For department use)
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 r Ga PLAN EXAMINATION AND
3 BUILDING PERMIT
z
IMPORTANT — Applicant to complete
/?0.4 all items in :sections: 1, 11, 111, IV, and IX. O
I• AT (LOCATION) / ` f� D�STR CT�� ,
LOCATION { ,/ (N 0.) (STREET)
9 �J
OF BETWEEN '5S I CSC p IL'i, __AND �' �j
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT_ BLOCK SIZE
to
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 Residential Nonresidential
2 ❑ Addition 0/residential, enter number 12 One family 18 ❑ Amusement, recreational
of new housing units added, if any, 13 ❑ Two or more family — Enter 19 ❑ Church, other religious
in Part D, 13) number of units— — — — --)P- 20❑ Industrial
3 ❑ Alteration (See 2 above) 14 l
Transient hotel, mote ,
❑ 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (If multifamily residential,
of units ——————— — --I 22 ❑ Service station, repair garage
enter number of units in building in 15 Garage 23 ❑ Hospital, institutional
Part D, 13) 16 ❑ Carport 24❑ Office, bank, professional
6 ❑ Moving (relocation) 17F-1 Other Specify
25 ❑ Public utility
—
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP / 27❑ Stores, mercantile
28 ❑ Tanks, towers
B ❑ Private (individual, corporation, 4,
nonprofit institution, etc.) JC ^/ t 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................ I 30®. et-o 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 ��Zn� 2--/31 Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area,all floors, based on exterior
32❑ Structural steel dimensions ..................... li`�
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
50. Total land area, sq. ft. ...........
34 ❑ Other — SpeciJy
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 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 ❑ Other — Specify Will there be an elevator? 54. Number of Full..........
bathrooms
46 ❑ Yes 47 No Partial.......
hereby certify that the proposed. work is authorized by the ow r of# t d
and I have been authorized by the owner hto make this _ ► cap c}
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED I Y TITLE _
DATE 19
DEPT. FILE COPY
zo
4DW.OF dt!WNG INSPECTIONS BUILDING
212 Main Swwt PERMIT
VALIDATION
ftdw.*W.16 Mass.01060 35 - 160
DATE October 12, 19 78 _ PERMIT NO. 'rot
APPLICANT Ri _haard Tam4ra ADDRESS an R
(N ) (STREET) (CONTR•S LICENSE)
NUMBER OF
PERMIT TO Wood Shed ( 1 ) STORY Wood Shed DWELLING UNITS 1
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) 779 Ryan Road DISTRICT URA
(N0.) (STREET)
BETWEEN Went and Tarrit[tE? AND 113X'S PJ t Rd.
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE 12 FT. WIDE BY 22 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: .Attach wood Shed to g!arame
AREA OR s
VOLUME ESTIMATED COST $ 300.00 FEEMiT 10.00
(CUBIC/SQUARE FEET)
OWNER Richard 1,amica
BUI
ADDRESS 779 Ryan Rd. , N'ton. BY
(Affidavit on reverse side of application to be completed by authorized ag t of owner)