12C-070 (9) Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
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NOTES and Data — (For department use)
IV. IDENTIFICATION To be completed by all applicants
Name Mailing address Number, street, city, and State ZIP code Tel. No.
Owner or
Lessee
2. Builder's
Contractor License No.
V MA
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.
Signat 7-090 pplicant_ Address Application date
0 0 NOT W R I T E BELOW T H I S L I N E
V. PLAN REVIEW RECORD For office use
Plan Review Dote Plans Date Plans
Plans Review Required Check Fee Started By Approved By Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obtained Number By Permit or Approval Check Obtained Number 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 FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued 19 'S"I"
Building Fire Grading
Permit Fee $ Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�. MASSACHUSETTS
r
$ 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. O
ZONING
I• AT (LOCATION) t�— ` =, S s"�' y`i'��-- DISTRICT
LOCATION ("O•) (STREET)
OF BETWEEN >u� — .;.' AND
BUILDING GROSS 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
1 ❑ New building Residential 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– – – – --),. 20 ❑ Industrial
3 Alteration (See 2 above)
14 I❑ Transient hotel, motel, 21 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 r_ Office, bank, professional
6 ❑ Moving (relocation)
17 Other – Specify 25 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,,,,,,,,,,,,,, 1
(��` 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 proposeruse.
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 ❑ Wood frame 41 [❑ Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 ❑ Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other – Specify 42 ❑ Public or private company 50. Total land ores, 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........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 ❑ Yes 45 —i No 53. Number of bedrooms..............
38 ❑ Cool
39 Other – Specify Will there be an elevator? Full..........
r 54. Number of
46 l Yes 47 I❑ No bathrooms
Partial.......
e DEPT': Or'BUILDING INSPECTIONS BUILDING o°
212 Main Street
IL
Northampton, MA7 01060 PERMIT .9
/0
12C - VALIDATION
DATE Feb 29. 1988 19 PERMIT NO. 81
APPLICANT .Arid i cnn 1 atP ADDRESS 42 Carolyn St. Uwner
(NQ.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO_ en (_1 STORY nnP Family DWELLING UNITS
( Y�FE 0 r�t IMPR ft NT) NO. (PROPOSED USE)
ZONING URA
AT (LOCATION) EE DISTRICT
(NO.) (ST T)
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 to install bay window
AREA OR
1 ,200.00 PERMIT ±0.00
VOLUME ESTIMATED COST . FEE
(CUBIC/SQUARE FEET)
OWNER Same as Applicant
BUILDING guof;J
ADDRESS Same as-Applicant's BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY P)N. P