18C-098 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.
NOTES and Data — (For deportment use)
•
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address - Number, street, city, and State ZIP codtf Tel. No
Owner or
Lessee
Builder's
2. /� License No.
Contractor
3. �/N� �j•
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 a thorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature of applicant Address Application date
r• c
DO 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
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 I
OIL BURNER WRECKING
OTHER OTHER
VII. VALIDATION
Building �n FOR DEPARTMENT USE ONLY
Permit number .
Building. 19 Use Group
•
Permit issued ry
Building %too" „ll Fire Grading
Permit Fee $ a` O”
Live Loading
Certificate of Occupancy $ Occupancy Load
Ap, -d by:
Drain Tile $ 5/
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
r
MASSACHUSETTS
C r
� ems. Ir • .i► ra OFFICE of the INSPECTOR of BUILDINGS
�� Page MSC Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT - Applicant to complete all items in sections: I, II, Ill, IV, and IX. 0
AT (LO NG I. 0 FRAYlC2' L .S S f \l- ZO C (1
LOCATION ( NO.) (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 -1
m
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For "Wrecking" most recent use m
m
-I
1 1 1 New building Residential Nonresidential
27 Addition (If residential, enter number 1 270n family 18 I I Amusement, recreational
J of new housing units added, if any,
in Part D, 13) 13 I I Two or more family - Enter 19 Li Church, other religious
number of units- - - - ---). 20 Li Industrial
3 I I Alteration (See 2 above) 14 I Transient hotel, motel,
�J 21 Li Parking garage
4 I I Repair, replacement or dormitory - Enter number
5
Li Wrecking (II multifamily residential,
of units - -0- 22 Li Service station, repair garage
enter number of units in building in 15 I I Garage 23 ❑ Hospital, institutional
Part D, 13)
16 I Carport 24 L I Office, bank, professional
6 I Moving (relocation)
L I 17,0ther - Specify WOO �� 25I I Public utility
7 J Foundation only
K 26 I 1 School, library, other educational
B. OWNERSHIP t '3 eX `\ 27 I Stores, mercantile
8 / Private (individual, corporation, 28 I Tanks, towers
nonprofit institution, etc.) 29 Li Other - Specify
9 I I 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 $ (24 "'"^ 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.
a . a. the above cost k2dt) 1 — � Electricaal l V , 1-40
b. Plumbing
c. Heating, air conditioning
d. Other (elevator, etc.)
11. TOTAL COST OF IMPROVEMENT $!A,1■•••■
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 / y� l
30I 1 Masonry (wall bearing) 40 Public or private company
49. Total square feet of floor area,
\ // Number of stories �/ / /�
31/ Wood frame 41 Private (septic tank, etc.)
all floors, based on exterior
32 Li Structural steel dimensions
33 Li Reinforced concrete H. TYPE OF WATER SUPPLY
34 I I Other - Specify 42 Public or private company 50. Total land area, sq. ft. L
43 I I Private (well, cistern) K. NUMBER OF OFF- STREET
PARKING SPACES
51. Enclosed
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 I Gas Will there be central air 52. Outdoors
36 I Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 L_j Electricity 44 Yes 4 L(No
C� 5 53. Number of bedrooms
38 Li Coal
39 I - 1 Other - Specify Will there be an elevator? 1 Full
54. Number of
46 Li Yes 47No bathrooms
/ Partial
Department of B Inspections BUILDING Main Street BUILDING Z°
Northampton, Mass. 01060 PERMIT f a
a J f 06 (....)(D VALIDATION
18C - 9
DATE May 21, 19 84 PERMIT NO. 203
APPLICANT Herbert B Goldsmith ADDRESS 30 Francis Street Owner
(NO.) (STREET) (CONTR'S LICENSE)
Addition onto Deck Onefamil Y Home NUMBER OF
PERMIT TO (1 STORY DWELLING UNITS _
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
30 Francis Street ZONING
AT (LOCATION) DISTRICT
_
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
DECK
liI&Xiag IS TO BE 8 FT. WIDE BY 10 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 DIX of a deck onto the front of the existing home
AREA OR 80 sq. ft. 120.00 PERMIT , 10.00
VOLUME ESTIMATED COST $ FEE
(CUBIC /SQUARE FEET)
OWNER Herbert B. Goldsmith
ADDRESS 30 Francis Street, Northamop) e ��
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY