25A-132 (5) Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YARD
SIDE YARD
1 SIDE YARD
REAR YARD
NOTES
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants '
�//Name Mailing address — Number, street, city, arm State ZIP code Teelll.. No.
1.Owner or
Lessee
Builder's
L
2• icense 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
55]
00 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 Approval Check Date Number B Permit or Approval Check Date Number B
Obtained Y pp Obtained Y
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
II. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number7`Ci
Bui Iding. -
Permit issued i:� - �. 19 Use Group
Building Fire Grading
Permit Fee $ (,n.( y
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by .,
Drain Tile $ J
/ t A
Plan Review Fee $
TITLE
e
CITY OF NORTHAMPTON
�. .e MASSACHUSETTS
$ e OFFICE of the INSPECTOR of BUILDINGS
t Page = Plot / -a APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O
—� ZONING f
I• AT (LOCATION) P t _ DISTRICT(
LOCATION (NO') (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
H
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 Residential Nonresidential
254 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- - - - -� 20 ❑ Industrial
3 ❑ Alteration (See 2 above)
14 ❑ Transient hotel, motel, 21 L❑ 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) ❑ 25 L❑ Public utility
17 Other - Speci/y
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,,,,,,,,,,,,,,,, )C 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..................... )oG 1
b. Plumbing .................... 7
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 company 48. Number of stories..............
31 Wood frame 41 ❑ Private (septic tank, etc.) 49• Total square feet of floor area, c�
all floors, based on exterior 9::; C�
32 ❑ Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
ect 42� Public or private company 50. Total land area, sq. ft. ...........
S
34 ❑ Other - p Jy
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
350 Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 ❑ Yes 45 No 53. Number of bedrooms..............
38 Coal
39 ❑ Other - Specify Will there be an elevator? 54. Number of Full..........
-
46 L❑ Yes 47§4No bathrooms
Partial.......
a DEPT. bF BUILDING INSPECTIONS BUILDING Z°_ 9
212 Main Street $a
Northampton, MA 01060 PERM IT
25A - 132 VALIDATION
DATE July 24, 1985 19 PERMIT 10. 436
APPLICANT Richard Smith ADDRESS 39 Day Ave. Owner
(NO.) (STREET) (CONTR•S LICENSE$
PERMIT TO Addition (_) STORY One Family NUMBER OF
DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING tTI�A
AT (LOCATION) 3 Day Ave. DISTRICT URA
(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 construction of an addition of a bedroom and bath onto existing
residential dwelling
AREA
VOLUME 950 sq. ft. addition ESTIMATED COST $ 25,000.00 FEEMIT 96.00
(CUBIC/SQUARE FEET)
OWNER Rgi�ch_ayrdd &eM�a Smiith„ �TT�----
ADDRESS J9 Da' y0 LrMLP0n, mass. BWLDING
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY ■ PINK - ASSESSORS COPY pjNT P