38B-134 (2) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
IX. SITE OR PLOT PLAN For Applicant Use
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants ,
Name Mailing address — Number, street, city, and State ZIP code Te1,.No.
1. /
Owner or
U O(l
Lessee
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
D0 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 Obta ned 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
OIL BURNER WRECKING
OTHER OTHER
VII. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number _ �o,-
Building. Use Group
Permit issued 7 19 F,!�; _
Building Fire Grading
Permit Fee $ A Live Loading
Certificate of Occupancy $ Occupancy Load
Appro ed by:
Drain Tile $ �
Plan Review Fee $
TITLE
;o o CITY OF NORTHAMPTON
MASSACHUSETTS
r t
$ e ,
OFFICE of the INSPECTOR of BUILDINGS
Page y Plot
g APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. 0
ZONING C�
I• AT (LOCATION) / /C f!� �.�([, L.Q.I. 4 DISTRICly
LOCATION N0.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vr
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
2X Addition(if residential, enter number 12'><One family 18 ❑ Amusement, recreational
of neru 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 (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)
17 Other — Specify 25 Public utility
7 ❑ Foundation only
r 26 ❑ School, library, other educational
B. OWNERSHIP 1� �(: r-�6 27 Stores, mercantile
8x Private (individual, corporation, �(y 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
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.)............. T/ /J
11. TOTAL COST OF IMPROVEMENT Is 10�D 0t✓
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
30❑ Masonry (wall bearing) 4� Public or private company 48. Number of stories..............
31 Wood frame 41 Private (septic tonk, 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 n( 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 I there be central air 52. Outdoors........................
36� oil con 'tinning?
L. RESIDENTIAL BUILDINGS ONLY
37E Electricity 44 ❑� s 45 n No 53. Number of bedrooms.............
38 ❑ Coal
39 ❑ Other — Specify Will ther a an evator? Full.......... /
54. Number of
46 Yes 47 I❑ No bathrooms /
Partial......
1
INSPECTION RECORD ,
DATE NOTE PROGRESS - CRITICISMS AND REMARKS INSPECTOR
DEPAETHM OF MUDUM USPECTIONS FIELD COPY
212 &zN STREET BUILDING
WRnIAMM v MA. 01060
3$$ ` 134 PERMIT
DATE KaxarihlT 41- 1980 PERMIT NO, 665
APPLICANT Silas Kalif ADDRESS I8 Steams Cotaxt
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Addition (--Z-) STORY Egtrvway DWELLING UNITS 1
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION)
18 Steo tilt D STR CT STAB
(NO.) (STRE
w BETWEEN AND i
m
(CROSS STREET) (CROSS STREET)
LOT
a SUBDIVISION OT BLOCK SIZE
m
a Addition
4(x&rw=IS TO BE 5 FT. WIDE BY�� T. L B FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
g (TYPE)
uO REMARKS: Addition of entMnM to front of oxistiAg resid@na
AREA OR 65p�04 PERMIT 1 ��
VOLUME ESTIMATED COST FEE
(CUBIC/SQUARE FEET)
f
OWNER Silas Kopf -
ADDRESS _ I8_ Stearns Ct,,.TNerthmptan, Ma. 01060 BUILD(
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