36-119 (4) Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YARD
REAR YARD
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IV. IDENTIFICATION — To be completed by all applicants
Nome { Mailing address — Number, street, c-ity, amf State ZIP code Tel. No.
Owner or
tI eo o r 7 ro C f' ( b G
L esa« 6)lotl0 �
Builder's
2. License No.
Contractor j
3.
Architect or
Engineer �.
1 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 �y Address ^ Application date
Z
? G k i cif' �.` //. Pi)c,, lyl� Z r
r
0 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans gy Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number B Permit or Approval Check Date Number B
Obtained y 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 j �� FOR DEPARTMENT USE ONLY
Permit number '-[
Building. use Group
Permit issued ( 19 S_
Building Fire Grading
Permit Fee $ � .�, '? Live Loading
Certificate of Occupancy $ Occupancy Load
Approved
Drain Tile $ �
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
�T Page 36 Plot L F APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. 0
,l ZONING
• AT (LOCATION) ' ✓""� /' _� DISTRICT
LOCATION (NO.) (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
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
m
1 ❑ New building Res id tial Nonresidential
2 �Addition(If 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- - - - -i — 20 ❑ Industrial
3 ❑ Alteration (See 2 above)
14 Transient hotel, motel,
4 ❑ Repair, replacement or dormitory - Enter number 21 Parking garage
❑
5 El Wrecking (If multifamily residential, of units ------- - -i 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 0 Other - Specify 25 E] Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP 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,,,,,,,,,,,,,,,, �''? school, secondary school, college, parochial school, parking garage for,
deportment 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 ..................... 'l
c. Heating, air conditioning........
d. Other(elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT $ y
III. SELECTED CHARACTERISTICS OF B I DING — 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 ❑ Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior /y
32 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. ........... C
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........................ l
36 ❑ Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 ❑ Yes 45 INO 53. Number of bedrooms..............
38 ❑ Coal �? �(/-
39❑ Other - Specify I� t/ i'Ll Will there be an elevator? Full..........
54. Number of
46 n Yes 47 No bathrooms
- Partial.......
a DEPT. OF BUILDING INSPECTIONS BUILDING ZO
3 212 Main Street 04
Northampton, MA 01060 PERMIT
36 - 119 VALIDATION
DATE August 22, 19 85 ARM T NO. 497
APPLICANT Patricia A. O'Leary ADDRESS BrooCsicTe Clrc�e owner
(NO.) (STREET) (CONTR'S LICENSE)
addition deck NUMBER OF
PERMIT TO (_) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 240 Brookside Circle ZONING URA
DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
DECK
16
I I� TO BE 12 FT. WIDE BY
S FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
PERMIT FOR THE ADDITION OF A DECK ONTO REAR OF EXISTING DVJEUING
REMARKS:
AREA OR 192 sq. ft. ESTIMATED COST $ 13000.00 FEEMIT � 10.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER Patricia & Craig Robitaille
roo sl a irc a Bu I LD
ADDRESS BY
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pINT- 1(P