35-007 (18) ZONING •
DISTRICT
FRONT YARD
SIDE YARD SIDE 'D
REAR YARD
NOTES
IX. SITE • • PLOT PLAN For Applicant
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NOTES and Data — (For department use)
r L
IV, IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, an(( State 4ZIP code Tel. No.
Owner or
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
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans B Notes
Fee Started Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number By Permit or Approval Check Dare Number B
Obtained Obtained 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
Permit number , -X J FOR DEPARTMENT USE ONLY
Building.
Permit issued G /�� 19 _ use Group
Building Fire Grading
Permit Fee $ )1,* C CU
Live Loading
Certificate of Occupancy $ Occupancy Load
rov, d by:
Drain Tile $
Plan Review Fee $
TITLE
. CITY OF NORTHAMPTON
�" '$ . , MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
Page `��� Plot 7 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)
,v9iu'�`"�'✓�!1 � DISTRICT N J3
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING CROSS STREET) CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
V1
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
—1
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 ❑ Transient hotel, motel, 21 ❑ parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (If multifamily residential, of units ——————— — 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) 25 ❑ Public utility
17 ❑ Other — Specify
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 V Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 ® Other — Specify
9 ❑ Public (Federal, State, or � U&C-
local government) VV
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..................... d �� t4TC-i�w,
b. Plumbing .....................
c. Heating, air conditioning.......... IV
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and addi ions, complete P is 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) 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........................
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 1—] Yes 45 XI No 53. Number of bedrooms..............
38 ❑ Coal
39 Other — .Specify Will there be an elevator? m Full..........
54. Number of
46 Yes 47 No bathrooms
C.71� Partial.......
DepartmAit of wilding Inspections BUILDING
212 Main Street ;° l
Northampton, Ma. J11060 PERMIT 2a �' od
a
35 - / VALIDATION
DATE October 13. 19 82 PERMIT NO. 5$0
APPLICANT Frederick R. Mailleux ADDRESS 15 West Fates Rd.. Fla-
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Alteration STORY DWELLING UNITS
RO _
(TYPE OF IMPROVEMENT) NO. (PPOSED U E)
ZONING
AT (LOCATION) 15 West Farms Road DISTRICT NR
(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: Rpmnyp P-xinting wA11 between store anti filt1sre video &ame room as skin axxiliaxy use
to main use of building.
AREA
VOLUME ESTIMATED COST $ 500,00 FEEMIT
(CUBIC/SQUARE FEET) f
OWNER Xa --- Six BUI O e
ADDRESS -1-5 W. Sams Fd,_�Fiorr 7nce, MSS 01060 BY
WHITE - FILE COPY • GREEN - FIELD COPY a CANARY - APPLICANT COPY • PINK - ASSESSORS COPY
_.o� .._ ._.��...:-�,,�P�,,..�r�,� .
r �
a
Department 4t`tuil4ding Inspections •� `BUILDING
'$UILDING
212 Main Street D°
Nor thwvton 0ifl 0 PERMIT 7a
* 5 ++ 7 VALIDATION
DATE Oct"er 130 19 A2 PERMIT NO. 580
APPLICANT Frederick R._ M&illoux ADDRESS 15 Liplm4. T1rrm�_T) it
doti F� -
(NO.) (STREE
. (CONTR'S LICENSE) -
NUMBER OF
PERMIT TO ®1LeTmit#.as (-I—) '$TORY Ikfi3Xfliix5 DWELLING UNITS
(TYPE OF IMPROVEMENT) NO (PROPOSED E)
ZNING
AT (LOCATION) 15 Vest rams Mad 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:
to main use of building.
AREA OR
VOLUME ESTIM TED COST $ �_QQ PERMIT i�
(CUBIC/SQUARE FEET) ' �r
OWNER >wRotias�iEk R, C�Ir,I►la � i110ax Bu D
ADDRESS BY
WHITE - FILE COPY GREEN - FIELDICOPY CANARY APPLICANT COPY PINK - ASSESSORS COPY
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