35-023 (6) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
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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.
It f
Owner or
Lessee
Builder's
L. 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
A
00 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 Permit or Approval Check Obtta ned Number By Permit or Approval Check obttaitned 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
Building- Use Group
Permit issued _ 19 0 :1 _
Building Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
Appro y
Drain Tile $
Plan Review Fee $
TITLE
o� CITY OF NORTHAMPTON
�• MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
T Page 34 Plot 23 APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
�'• ZONING
I• AT (LOCATION) -'� It�.'" DISTRICT��
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
IL 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
2❑ Addition(I/ 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)
17 ❑ Other — Specify �r L2 25 ❑ Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWN SHIP �lL— 27 ❑ Stores, mercantile
8 ❑Private (individual, corporation, r 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
f' processing plant, machine shop, laundry building at hospital, elementary
± school, secondary school, college, parochial school, parking garage for,
10. Cost of improvement,,,,,,,,,,,,,,,,
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.)............
11. TOTAL COST OF IMPROVEMENT Is }
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 1
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 . t
32 ❑ Structural steel dimensions
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other — Specify 42 ❑ Public or private company 50. Total land ores, sq. ft. ..........
43 ❑ Private (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 be an elevator? Full..........
54. Number of
46 ❑ Yes 47 ❑ No bathrooms
Partial.......
Department of Building Inspections
212 Main St.
T:ortampton, -14ass. ' 01060 BUILDING
PERMIT Qa $10.00
XXXX 35 - 23
VALIDATION
DATE June 6, 19 84 PERMIT NO. 228
APPLICANT Dennis A. Seymour ADDRESS 50 WPGt XXXXX Farms RA_ Owner
(NO.) (STREET) (CONTR'S LICENSE)
Shed NUMBER OF
PERMIT TO New Building (_) STORY DWELLING UNITS -
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
50 WEst Farms Rd. ZONING CT SR
AT (LOCATION)
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE 12 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 to construct a new auxilary building in the rear of exieting hnme
AREA OR PER MIT
144 Sq• ft. ESTIMATED COST $ 4'00.0° _FEE � 10.00
VOLUME (CUBIC/SQUARE FEET)
I f
OWNER Dennis A, Seymour '�'//'j,j''//
West arms Rd. BBUILDIN�-���1�
ADDRESS
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY ■ PINK - ASSESSORS COPY