29-261 Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
Ix. SITE OR PLOT PLAN For A-pp-licont 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 Tel. No.
Owner or \
Lessee 'e
t/ Builder's
1' 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 applicat n Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans
Fee Started y Approved BY Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number By Permit or Approval Check Date Number B
Obtained Obtained Y
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 <
Permit issued /
qT 19 D use Group
_
Building Fire Grading
Permit Fee $ f�iC�
Live Loading
Certificate of Occupancy $ Occupancy Load
Approve by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
$ OFFICE of the, INSPECTOR of BUILDINGS
Page Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. C)
ZONING ..pp''''
I• AT (LOCATION) ,
" /� e,l i�K- 1� �" l / fe OISTRICTJ
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
M
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
1 F--1 New building Residential Nonresidential
2 � Addition(If residential, enter number 12 One family 18 Amusement, recreational
of new 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 l
l
h
Transient hotel, mote ,
C� 21 Parking garage
4 El Repair, replacement or dormitory — Enter number
5 Wrecking (1/ multifamily residential,
of units ——————— — -i 22 Service station, repair garage
enter number of units in building to 15 Garage 23 Hospital, institutional
Part D, 13) 16 Carport 24 Office, bank, professional
6 � Moving (relocation) p
g ) 17 Other - Specify 25 Public utility
7 D Foundation only 26 School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 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
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement................ ' `00 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.....................
n' Alt:�,e dz z,<J-&of
b. Plumbing ..................... t
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
41 Private (septic tank, etc.) 49. Total square feet of floor area,
31 Wood frame p all floors, based on exterior
32 Structural steel dimensions ..................... s1
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
35E] Gas Will there be central air 52. Outdoors........................
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 Cf Electricity 44 Yes 45 No 53. Number of bedrooms..............
38 Coal
39 n Other — Specify Will there be an elevator? 54. Number of Full..........
Y] No bathrooms
46 � Yes 471 Partial........
DEPT. O 1 ING INSPECTIONS BUILDING Z°
ain Street o a
P •(:.�C
Northam ton 1 MA 01060 PERMIT I /
29 - 261 VALIDATION
PATE April 9, 87-�-- PER IT N0. 175
APPLICANT Ronald & Gail Perrier ADDRESS rooKside �Ir. wner
(N0.) (STREET) (CONTR'S LICENSE)
PERMIT TO
Addition STORY Deck NUMBER OF
(_)
(TYPE OF IMPROVEMENT) N0. (PROPOSED USE) DWELLING UNITS
380 Brookside Cir. ZONING URA
AT (LOCATION) DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
yy
DECK
"*",, TO BE 10 FT. WIDE BY 12 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: permit for the addition of an attached deck to back of existing dwelling
AREA OR VOLUME 120 sq. ft• ESTIMATED COST $ 300.00 FEEMIT $ 10.00
(CUBIC/SQUARE FEET) j�_
OWNER BUIL
ADDRESS BY
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY • PINK - ASSESSORS COPY Olp