17C-016 (4) ZONING •
i FRONT YARD
IX. SITE 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, city, and State ZIP code Tel. No.
t.
Owner or
Lessee �a� WGI y M�
2. a°%4a + bbe �{ 8Pt1211�G� .�.� Builder's OgGS7
���, License No. v�`
Contractor i
Itt. 7`i 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 is authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Sign re f li ant Address Application date
t� qJter✓Ien �tI. Qt��t g-Z3
00 NOT WRITE BELO THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
ate Date
Permit or Approval Check ObDta ned 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
Buildingp FOR DEPARTMENT USE ONLY
Permit numberJJ
Building Use Group
Permit issued 19 _
Building Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Oc p cy Load
Drain Tile $
Approved b
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�. MASSACHUSETTS
e OFFICE of th INSPECTOR of BUILDINGS
,�T Page 12 Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT - Applicant to complete all items in sections: 1, 11, Ill, IV, and IX. O
((��
ZONING
I• AT (LOCATION) 110 � A10(ly DISTRICT
LOCATION (N 0.) (STREET)
OF BETWEEN AND Pit,i✓% S# ��et"°`Cs P__
BUILDING ROSS 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
m
1 ❑ New building Residential Nonresidential
2[—] Addition(If residential, enter number 12 D One family 18 Amusement, recreational
of new housing units added, if any,
in Part D, ]3) 13� Two or more family — Enter 19 Church, other religious
number of units— — — — -- 20 Industrial
3*$k�Alteration (See 2 above)
14 _ 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 nurnber of units in building in 15 Garage 23 �_� Hospital, institutional
Part D, ]3) 16 r Carport 24 � Office, bank, professional
6 Moving (relocation) P
17 11 Other – Specifv _ 25 Public utility
7 r� Foundation only
26 �_� School, library, other educational
B. OWNERSHIP ___ 27 j Stores, mercantile
8 Private (individual, corporation, 28 i Tanks, towers
nonprofit institution, etc.) _ 29 Other – .Specify
9 Public (Federal, State, or
local government)
C. COST i (Un11t cents,! Nonresidential — Describe in detail proposed use of buildings, e.g., food
15 ADO orocessing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,,,,.,,,•..... J oo school, secondary school, college, parochial school, parking garage for
—�— department store, rental office building, office building at industrial plant.
7o be installed but not includc i I If use of existing building is being changed, enter proposed use.
in the above cost
a. Electrical.... 0 0
000r
b. Plumbing ....................... 1000.00
'
c. Heating, air conditioning........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $ r~, 500.
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 L] Masonry (wall bearing) 405+C', Public or private company 48. Number of stories...............
31 Wood Frame 41 Private (septic tank, etc.) 49. Total square feet of floor area,
ail floors, based on exterior
32 JI Structural steel dimensions .....................
33 �j Reinforced concrete H. TYPE OF WATER SUPPLY
-- private company 50. Total land area, sq. ft. ...
34
�, Other – S ci 42! �' Public or p c� l` P —
43 Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEjT1 G FUEL CTYPE OF MECHANICAL
35 11 Gas Will there be central air 52. Outdoors........................
36 1 Oil ""'�*3;,, ` conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 �_ Electricity 44 Yes 45 No
__. . 53. Number of bedrooms..............
,8 [7, Coal
39 Other — Specify Will there be an elevotoro Full..........
54. Number of
46 Yes 47 ! No bathrooms
,' — Partial.......
.- � ,
'��1 ,4,4
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••�i \F{
`DEPT. OF BUILDING INSPECTIONS BUILDING Z0
+ ! 212 Main Street Oa (�
Northampton, MA 01060 PERMIT
17C - 16 VALIDATION
DATE August 23, 19 88 PERMIT NO. 538
APPLICANT Randall F_ Robprt,, ADDRESS 41 Hemenway Rd. , Leverett Mass. 042573
(NO.) (STREET) (CONTR'! LICENSE)
NUMBER OF
PERMIT TO AlteratiAns (_) STORY Two Family DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) i in Nnrth Maple Street 0IISTR CT URB
(NO.) ISTREET)
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 interior remodeling of existing first floor kitchen
AREA OR 1 7�500 PE 1 64.00
VOLUME ESTIMATED COST FE $(CUBIC/lO DARE FEET)
OWNER Barbara & Toby Rockwell B I� �,•..•�'•�
ADDRESS 110 North Maple Street B
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY p�Rf' P