28-040 Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YARD
REAR YARD
1 IX. SITE OR PLOT PLAN For Applicant Use
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NOTES and Data — (For department use)
O
�'e (rz# of 'NorfiYamptalt
M �
� e �R558CI�li5ttt5 �
psi DEPARTMENT OF BUILDIXG INSPECTIONS
F
INSPECTOR 212 Main Street ' Municipal Building °
Northampton, Mass. 01060
AS A HOMEOWNER I UNDERSTAND THAT I MAY APPLY FOR AND RECEIVE
A BUILDING PERMIT FOR A HOME OR ADDITION I INTEND TO LIVE IN.
I ALSO UNDERSTAND THAT I AM RESPONSIBLE FOR KNOWING THE STATE
BUILDING CODE AND ZONING ORDINANCE OF THE CITY OF NORTHAMPTON.
BEING A HOMEOWNER AND NOT A PROFESSIONAL CONTRACTOR IN NO WAY
ABSOLVES ME OF ANY RESPONSIBILITY TO INSURE THAT ALL FACETS
OF THE RULES AND REGULATIONS ARE COMPLIED WITH.
Y \
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
O
Owner or
Lessee ' 9
FZC'
Bui lder's
1' +L''k License No.
Contractor
r
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.
1
Signature of applicant i:V y� Application date
O i G C)
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 Approval Check Date Number 8 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
VII. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building f� Use Group
Permit issued 19
Building Fire Grading
��
Permit Fee $ �� C4- -fib-
Live Loading
Certificate of Occupancy $ Occupancy Load
A proved by:
Drain Tile $
Plan Review Fee $ >�
TITLE
CITY OF NORTHAMPTON
so MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. 0
ZONING
AT (LOCATION) ,. ,i DISTRICT
I•
LOCATION IN O') (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
V1
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
-a
1 F-1 New building Residential Nonresidential
2'X.Addition(ff 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 �_� Parking garage
4 Repair, replacement or dormitory - Frtter number
5 � Wrecking (If multi/amity residential,
of units ------- - -� 22 � Service station, repair garage
enter number of units in building in 15 Garage 23 n Hospital, institutional
Part D, 13) 16 carport
24 Office, bank, professional
❑
6 F-1 Moving (relocation) 25 Public utility
17 Other - Specify
7 ❑ Foundation only 26 School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
28 n Tanks, towers
8 Private (i I.ndivid„° 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
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement.......... / 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 4. Z
a. Electrical...................... d
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 C Public or private company Private ( c tank, etc.) 49. Total square feet floor area, X,,�J w
4.1 (septic 31 Wood frame � p all floors, based on exterior
32 Structural steel dimensions ..................... 124.l
33 Reinforced concrete H. TYPE OF WATER SUPPLY
50. Total land area, sq. ft. ...........
34 Other - Specify
42 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 LD Gas Will there be central air 52. Outdoors........................
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 n Yes 45No 53. Number of bedrooms..............
38 Coal
39 n Other - Specify Will there be an elevator° Full..........
54. fJumber of
46 [ bathrooms
1 Yes 47�No Partial,,......
DEPT. OF BUILDING INSPECTIONS BUILDING
+ ! 212 Main Street O<
Northampton, MA 01060 PERMIT
28 _ 40 VALIDATION
DATE May 15, ] 89 307
APPLICANT XROX Donald Upham ADDRESS
yan dPERMIT NO.
(NO.) (STREET) (CONTR'S LICENSE)
One Fami 1 NUMBER OF
PERMIT TO Addition ( ) STORY y DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING bK
AT (LOCATION)
723 Ryan Rd. 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: nPrmit, for added kitchl�n area
AREA OR ESTIMATED COST 15,000.00 FEEMIT 52.00
VOLUME 77a C(1 - l _
( UBIC/SQUARE FEET)
OWNER SAMin AS ATT l j rant. BUIL
ADDRESS ,Kym?-a�.A Brant I BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY p.1 'p