36-131 (8) Vill.-ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
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, ciitv,`and State ZIP code Tel. No.
Owner or 0• — ^'q-�` ' v
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
AP . (I—L" — 1
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans
Fee Started y Approved By Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approva I Check Date Number By or Permit Approval I Check B Date Number
Obtained pp 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 �f FOR DEPARTMENT USE ONLY
Permit number �.
Building C�G:f.�l l Z...
Use Group
Permit issued 19
Bur(ding ` O Q � Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
o d by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
g. MASSACHUSETTS
r •
$ OFFICE of the INSPECTOR of BUILDINGS
Page
w3G -Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. C)
//JJ
ZONING a,q
I• AT (LOCATION)
DISTRIC __ 11
LOCATION (N0•) (STREET)
OF BETWEEN AND
BUILDING {CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
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
rn
1 ❑ New building Residential Nonresidential
2 D Addition(If residential, enter number 12 X One family 18 Amusement, recreational
of new bousing units added, if any,
in Part D, 13) 1371 Two or more family - Enter 19 � Church, other religious
number of units- - - - --> 20 Industrial
3 F-1 Alteration (See 2 above)
14 E] Transient hotel, motel, 21 Parking garage
4 Repair, replacement or dormitory - Enter number
5 Wrecking (If multifamily residential, of units ------- - -- 22 L� 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 270 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................ -"Q'• 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
30❑ Masonry (wall bearing) 40 Public or private company 48. Number of stories..............
31 g Wood frame 41 Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior
32F--] 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........................
conditioning?
36 ❑ Oil L. RESIDENTIAL BUILDINGS ONLY
37 C) Electricity 44 n Yes 45ljt No 53. Number of bedrooms..............
38 Coal j
39 n Other - Specify Will there be an elevators 54. Number of Full.j j.......
-
46 Yes 471%_JA No bathrooms
Partial........
ti
DEPT. OF BUILDING INSPECTIONS BUILDING Z°
! 212 Main Street 0 ' f
Northampton, MA 01060 PERMIT
36 - 1310 VALIDATION
DATE April 11, 19 86 PERMIT NO. 151
APPLICANT Oscar Johnson ADDRESS 295 Brookside Circle
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO New Building (`) STORY One Family DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
295 Brookside Circle ZONING URA
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: perrnit for a new garage and breezway
AREA VOLUME ESTIMATED COST $ 2,500.00 FEE MIT $ lo_oo
(CUBIC/SQUARE FEET)
1 � a
Same as Applicant - -1
OWNER BUIL01
ADDRESS BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY ■ PINK - ASSESSORS COPY pop