35-184 ZONING •
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
IX. SITE x
OR PLOT
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IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
Owner or
Lessee
S -�Z� k �o� 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 application as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature 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 Approva I Check Obtained Number By Permit or Approval Check Obtta t ed 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 y
Building Use Group
Permit issued 19
Building Fire Grading
Permit Fee $ )lo
Live Loading
Certificate of Occupancy $ occupancy Load
Approved b
Drain Tile ``
Plan Review Fee $
TITLE
dirt'' r
- CITY OF NORTHAMPTON
�• .e MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
t Page Plot 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
AT (LOCATION) w DISTRICT
LOCATION P1 (NO.) ' (S ET)
OF BETWEEN AND
BUILDING (C OSS STREET) V (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
H
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(If 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— — — — —>
2 Industrial
3 ❑ Alteration (See 2 above) ❑
14 ❑ Transient hotel, motel, 21 1 C � Parking garage
4 [o Repair, replacement or dormitory — Enter number
_----__ — 22 ❑ Service station, repair garage
5 ❑ Wrecking (l(multifamily residential, of units --30-- _
enter number of units in building in 15 Garage 23 Hospital, institutional
Part D, 13) ❑
16 Carport 24 C] Office, bank, professional
6 ❑ Moving (relocation)
17 L� Other — Sped/y 25 ❑ Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP G 27 Stores, mercantile
8 V 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
�y�o processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,,,,,,,,,,,,,, (/CJ 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 1
x
a. Electrical.....................
b. Plumbing ......................
i
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $60,00 O)
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 W.
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 � 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........................
conditioning?
36 � Oil L. RESIDENTIAL BUILDINGS ONLY
37❑ Electricity 44 ❑ Yes 45 ! No 53. Number of bedrooms..............
38 ❑ Coal
39 C❑ Other — Specify Will there be an elevators Full..........
— 54. Number of
46 [—] Yes 47 / I No bathrooms
J---' Partial.......
DEPT OF BUILDING INSPECTIONS BUILDING z
! 212 Main Street
Ia. () I ' 06
Northampton, MA 01060 PERMIT
35 - 184 VALIDATION
DATE July ADO DRESS I��x 203 R East�iamp on 472 Owner
APPLICANT Nelson Roberts
(NO.) (STREET) (CONTR•S LICENSE)
New Buildin g Gara e/Pla room NUMBER OF
PERMIT TO I_) STORY 9 Y DWELLING UNITS
(TYPE Of IMPROVEMENT) NO. (PROPOSED USE)
6 Pine Valley Road ZONING CT SR
AT (LOCATION)
(NO.) (STREET).
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBOWISION 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, permit for the construction of a detached garage and playroom area (combined)
AREA OR ESTIMATED COST $ 6,000.0 FEEMIT .�
VOLUME XX$S 24.00
(CUBIC/SQUARE FEET)
OWNER Same as Applicant
BUILDI
ADDRESS Same as Applicant's BY
WHITE — FILE COPY . GREEN — FIELD COPY ■ CANARY ^ APPLICANT COPY • PINK - AS ESSORS COPY p'INT NP