35-132 (6) ZONING •
DISTRICT
IX. SITE OR PLOT
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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 a I Rms b oe am tD A) o,*E) S84 96
Lessee
Builder's
Z.
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
6 �
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re wired Check Plan Review Date Plans By Plans B Notes
q Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL Is
OTHER Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date
Permit or Approval Check Obtaatned Number By Permit or Approval Check Obtained 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 l _J
Building L Use Group
Permit issued �� J.T ` �l 19
Building
�—�— Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved bynn.
Drain Tile $ 1#
Plan Review Fee $ f
TITLE
CITY OF NORTHAMPTON
g* MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
,VT Page Plot °- APPLICATION FOR
INSPECTOR l ��'" ! ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: I, II, 111, IV, and IX. O
X CJ C(� DO TR CT �90
AT (LOCATION) i'C—S.
LOCATION //y� +' IN 0.) !, T R E E T) )
OF BETWEEN r'�VA1V pCu AND l/fl'_'7
BUILDING (CROSS STREET) (CROSS STREET)
LOT / F
SUBDIVISION LOT BLOCK SIZE
Vr
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 F-1 ew building Residential Nonresidential
2 Addition(1/ residential, enter number 12 One family 18 � Amusement, recreational
of new bousing 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 L Parking garage
4 Repair, replacement or dormitory — Enter number -
5 �_ Wrecking (11 multifamily residential, of units ------- — 22 Service station, repair garage
enter number of units in building in 15 �� Garage 23 �� Hospital, institutional
Part D, 13)
6 Moving (relocation) 16 ���arport /� 24 Office, bank, professional
7 Foundation only 17 L�!l 0ther — Speci/y (j 24 25 '� Public utility
C
p26 _J School, library, other educational
B. OWNERSHIP i 27 L Stores, mercantile
8 L Private (individual, corporation, 28 Tanks, towers
nonprofit institution, etc.) 29 Other — .Specify
9 n Public (Federal, State, or
local government)
C. COST (O-nit 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,,,,,,,,,,,,,,,, Q D 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 chm°,ged, enter proposed use.
in The above cost
a. Electrical.......................
b. Plumbing .......................
c. Heating, air conditioning.......... 0
d. Other (elevator, etc.).............1 0
11. TOTAL COST OF IMPROVEMENT Is 3 D D O
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 CJ Masonry (wall bearing) 40 j i:lic or private company Number of stories...............
31 Wood frame 41 D Private (septic tank, etc.) 49. Total square feet n floor area,
❑ all floors, based on exterior 3 S/F
32 Structural steel N' A � dimensions .....................
33 n Reinforced concrete H. TYPG '7F WATER SUPPLY
34 � Other - Specify 421-1 Public or private company 5C. Total land area, sq. Ft. ..........
4� I Private (well, cistern) K. NUMBER OF OFF-STREET
A PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 f ] Gas Will there be central air 52. Outdoors........................
conditionin
36 � Jil 9 L. RESIDENTIAL BUILDINGS ONLY
37 L Electricity 44 r Yes 45XNo 55. Number of bedrooms..............
38 Coal
39 Other — Specify rJ- A. Will there be an elevators Full..........
54. Number of
46 Yes 47 No bathrooms partial........
s
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DEPT. OF BUILDING INSPECTIONS BUILDING �° J'), /-)L
! 212 Main Street Ia c
Northampton, MA 01060 PERMIT
35 - 132 VALIDATION
B. DATE Sept_ 7 PERMIT NO.
B
APPLICANT Pamela . Williams ADDRESS )� yan d. ,
(NO.) (STREET) (CONTR'S LICENSE)
One Fami 1 NUMBER OF
PERMIT TO Addition (_) STORY y DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ZONING URA KKAss K
AT (LOCATION)
716 Ryan Road 0IISTR CT
(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: permit to Close In porch
AREA OR 3,000.00 PER .�' 12.00
VOLUME XR%AXX 253 sq. ft. ESTIMATED COST
(CUBIC/SQUARE FEET)
OWNER Same as A)pl i rant eul
ADDRESS Same a S A--a I S 8Y
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK ASSESSORS COPY P0.1p
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