35-077 (12) Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
IX. SITE OR PLOT Applicant
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NOTES and Data — (For department use)
°
IV. IDENTIFICATION To be completed by a// applicants
Name Mailing address Number, street, citY, and State ZIP code Tel. No.
Owner
Lessee
License No.
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.
Sign/cV4re of applicant Address Application date
V. PLAN REVIEW RECORD For office use
Plans Review Required Check Plan Review Date,Plans By Date Plans By Notes
Fee Sta ted Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date cki Date
Permit or Approval Check Obtained Number By Permit or Approval Che Obta ined 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 I
OTHER OTHER
VII. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued Cr/ 19
Building 0 Fire Grading
Permit Fee $ Live Loading
Occupancy Load
Certificate of Occupancy $
Drain Tile $
Plan Review Fee $
U,
TITLE -
CITY OF NORTHAMPTON
�• �:� MASSACHUSETTS
r �
$4l OFFICE of the INSPECTOR of BUILDINGS
v UT Page �� � Plot 7'J APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT - Applicant to complete all items in sections: I, 1I, 111, IV, and IX. O
ZONING
I• AT (LOCATION) I ✓I r°� 4L11- DISTRICTS
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
M
1 ❑ New building R14idential Nonresidential
2 Addition residential, enter number
❑ J 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 25 ❑ Public utility
7 ❑ Foundation only
If 01 "1 26 ❑ School, library, other educational
B. OWNERSHIP V� t� 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,,,,,,•,,,,,,,,, (1 -y ,G' 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.)............. F ll
11. TOTAL COST OF IMPROVEMENT $[D dV
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) 40 ❑ Public or private company 48• Number of stories..............
31 Wood frame 41—N Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior
32 ❑ Structural steel dimensions .....................
33 ❑ Reinforced concrete H. T�E 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
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed .......................
❑ Gas Will there be central air 52. Outdoors........................
36 ] Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 ❑] Yes 45 F�_j No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Speci/y Will there be an elevator° Full..........
� 54. Number of
46 ❑ l Yes 47 y 1 No bathrooms
Partial.......
Department of Buirdxng Inspections
212 Main Street BUILDING ��
Northampton, Mass, 01060 <a >
p PERMIT
35 - 77 VALIDATION
DATE August 4, i9- 83 PERMIT NO. 384
APPLICANT Diana L. Hayden ADDRESS 842 Ryan Road N/A
(N0.) (STREET) (CONTR'S LICENSE)
Inground Swimming Pool One Family NUMBER of
PERMIT TO (`) STORY DWELLING UNITS _
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) 842 Ryan Road D STR CT SR
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREETI
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE 18 FT. WIDE BY 36 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: permit to install a ingenund Awimming pool
AREA OR 648 sq. ft. ESTIMATED COST $ 10,894.00 PERMIT $ 44.00
(CUBIC/SQUARE FEET)
OWNER Robert & Diana Hayden
ADDRESS 842 Ryan Road DYI
WHITE - FILE COPY - GREEN - FIELD COPY ■ CANARY - APPLICANT COPY - PINK - ASSESSORS COPY