28-062 (3) Vill. ZONING PLAN EXAMINERS NOTES
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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.
j�I
Owner or d l
Lessee
Bui Ider's
2. Sf License No.
Contractor
,u �
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 I Address Application date
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 Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date D
Permit or Approval 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 ! '1 FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued `'. 19 "t_
Building c+ Fire Grading
Permit Fee $ f *-
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
a
t
TITLE
CITY OF NORTHAMPTON
�. .� MASSACHUSETTS
r �
$ d OFFICE of the INSPECTOR of BUILD NGS
t
Page —C 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
I• AT (LOCATION) ) DISTRICT
LOCATION (NO.) V ( REET)
OF BETWEEN AND
BUILDING (CROSS STREE') (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — Alf applicants complete Parts A — D X
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use rn
rn
-a
1 ❑ New building Re 'd ntial Nonresidential
20 Addition(If residential, enter number 12 One family 18 ❑ Amusement, recreational
of new housing units added, iJ any,
in Part D, 13) 13 Two or more family - Enter 19❑ Church, other religious
number of units- - - - -I 20❑ Industrial
3 ❑ Alteration (See 2 above)
14 ❑ Transient hotel, motel, 21 El Parkin
4❑ Repair, replacement g garage
p p or dormitory - Enter number
5❑ Wrecking (II 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
26❑ School, library, other educational
B. OWNERSHIP 27❑� Stores, mercantile
8 E] 28 Tanks, towers Private (individual, corporation, Il�. ±l'td k ' �,` �.,,".: ❑
nonprofit institution, etc.) 29 O r Other - Specify
r
9 ❑ Public (Federal, State, or 1`~ t - t,P* 4 d'
local government)
C. COST (Omit cents) Nonresidential - Describe in detail proposed use of buildings, e.g., food
r^p^ processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement•••••••••,••,••• If 1 t 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 ^ I !)
a. Electrical..................... I flfil 01
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 afl others skip to IV.
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..............
49. Total square feet of floor area
31 ❑ Wood frame 41 ❑_ Private (septic tank, etc.) all floors, based on exterior
32 ❑ Structural steel dimensions
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
50. Total land area, sq. ft. ...........
34 ❑ Other - Specify 42 Public or private company
43 ❑ Pri�eote (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ......................
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 De an e!evatoO Full..........
54. Number of
46 Yes 47 No bathrooms
Partial........
DEA` .10FBUILDING INSPECTIONS BUILDING z
+ 212 Main Street
Northampton, MA 01060 PERMIT <
28 - 62--5 VALIDATION
DATE March 17, 19 88 PERMIT NO. 125
APPLICANT Jim Boyle _ ADDRESS 266 West Farms Road 006863
IND.) (STREET) (CONTR'S LICENSE)
ER OF
PERMIT TO AddPd Sa_ Ft._ (_) STOPY New Single Family Dwell���LLING UNITS
(TYPE OF IM0ROVEMENT) NO. (PROPOSED USE)
ZONING SR
AT (LOCATION) Lot #5 Ryan Road DISTRICT
(NO.) (STREET)
BETWEEN AND
- (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION _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: nPrmlt fnr raddpd Co_ft nnt.n nPw C1ngle family CiwellinQ/changers from 1__floor with
garage, to a raised ranch with garage
AREA OR
PERMIT
VOLUME 1 R4 11PW l ft ESTIMATED COST $ gg,noo_00 FEE $ 147.00
(CUBIC/SO Cf ARE FEET)
OWNER Same 3$ Annet BUILDING DEJ,6.�
ADDRESS SaMP aC Applicant BY (y�
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pop