35-184 (2) V-111. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YARD
SIDE YARD SIDE
IX. SITE OR PLOT PLAN For Applicant Use
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NOTES and Data — (For department use)
cy
',000,/P�ccti
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
1.
Owner or '^r" ( tC L° / �/• /, !)? �� D�Q-G� L��(L7��>/�
Lessee
B
2 /� �� �� uilder's
/Y7 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 Plans
Fee Started Y Approved BY Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number B Permit or Approval Check Obtained Number By
Obtained y PP
BOILER PLUMBING
CURB OR SIDEWALK CUT ROOFING
ELEVATOR SEWER
ELECTRICAL SIGN OR BILLBOARD
FURNACE STLOFPUBLIC ADES
GRADING US AREAS OIL BURNER WOTHER OT
VII. VALIDATION
Building t 1�1� FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued Iq
Building Y Fire Grading
Permit Fee $ lG •C9a
Live Loading
Certificate of Occupancy $ Occupancy Load
Appro d by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
9 MASSACHUSETTS
$ e OFFICE of the INSPECTOR of BUILDINGS
Page Plot 8 APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items/in.`sections: 1, 11, III, IV, and IX. O DISTRICT
ZONING
I• AT (LOCATION) �
LOCATION (NO.)S /�j /�// (STREET) /J
OF BETWEEN ! 412 /7J ( tC1 G�{,�! AND / _/ GC-1 -
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vt
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
M
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
-f
1 New building Resid ntial Nonresidential
2 Addition(If residential, enter number 12 One family 18 Amusement, recreational
of new housing units added, if any, 13 Two or more family - Enter 19 n Church, other religious
in Part D, 13)
number of units- - 20 Industrial
3 Alteration (See 2 above) 14 Transient hotel, motel,
21 C � Pinking garage
4 Repair, replacement or dormitory—= Enter number
�
5 Wrecking (1/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 E:] Other —'Specify
7 Foundation only 26 School, library, other educational
B. OWNERSHIP 270 Stores, mercantile
28 Tanks, towers
8 Private (individual, corporation,
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
may' processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement................ Z0�.( 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.).............
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 all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
48. Number of stories...............
30 Masonry (wall bearing) 40 D Public or private company
41 Private (septic tank, etc.) 49. Total square feet of floor area,
31 Wood frame P 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 [g Public or private company
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 C1 Electricity 44 [-] Yes 45 No 53. Number of bedrooms..............
38 Coal
39 Other — Specify Will there be an elevator' Full..........
54. Number of
f—I
46 l Yes 47 'J No bathrooms Partial........
a DEPT. OF BUILDING INSPECTIONS BUILDINL,
! 212 Main Street
Northampton, MA 01060 PERMIT r
VALIDATI,.
35 - 184 p
DATE August 22,-- )g 86 PERMIT NO. 485
APPLICANT Nelson H. Roberts ADDRESS P.O. Box 203 Easthampton Owner
(NO.) (STREET) (CONTR'S LICENSE)
Alteration NUMBER OF
PERMIT TO (_) STORY Single FAmily DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
6 Pine Valley Road ZONING SR
AT (LOCATION) 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; Permit for the repair of roof
AREA OR ESTIMATED COST $ 4000.00 FEEMIT 16.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER Same as Applicant,
B ,
U I L D'EPT. ///�//��
ADDRESS Same As Applicant ' s BY .�p . ..r-A:d-
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK 1- ASSESSORS COPY pOfp
DEPT OFD BUILDING INSPECTIONS Z o A
212 Main Street BUILDING IL f
Northampton, MA 01060 PERMIT
[q• VALIDATION
DATE �`. ` 19 PERMIT NO.
)4 q.
APPLICANT 1 � C'4� ADDRESS P
(NO.) (STREET) (CONTR'S LICENSEI
PERMIT TO . L. (�) STORY 1.i1 `" { DWELLRING UNITS
(TYPE OF IMPROVEMENT) NO. ,,aa (PROPOSED USE)
�'� l i?' k°+ !S ZONING C f°,
AT (LOCATION) 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: -Io 1r1 C. or 11 e
AREA OR PERMIT ar
VOLUME ESTIMATED COST $ tl i i J FEE <
(CUBIC/SQUARE FEET)
OWNER Same as iA.^ p e'
BUILD
ADDRESS ,�� As BY — - -
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY p P