03-010 (5) ZONING
FRONT
SIDE YARD SIDE YARD
REAR YARD
X. SITE OR PLOT
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-------------- ISBN ME I am U011180-11 RUN!-sari"M A 101 Wrl 101-04 gmUM t
NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, a State ZIP code /Tel. No.
Owner or t .-/.i/sue �c=-✓," � <� _ s^ .�'. f� _ .+:. �'/` //C,- G�/ C p` (,� j';
Lessee
Builder's
2. License 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.
Signatur 7an,
plicont Address Application date
L ��C
00 NOT WRITE BELOW 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
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 V�Q�t '1 _ 19 t .
Building $ Q� ��
Fire Grading
Permit Fee �b
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
f CITY OF NORTHAMPTON
�. MASSACHUSETTS
$ B OFFICE of the INSPECTOR of BUILDINGS
,�, Page 7 Plot �� APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
y F ZONING
I. AT (LOCATION) / / I I DISTRICT
LOCATION "° ' STREET)
OF BETWEEN :z )�-L �: AND f t �/ ♦FZf
BUILDING (CRO• LO STREET) (CR ST HE ET)
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
1X New building Residential Nonresidential
2 EI Addition(If residential, enter number 12F-1 One family 18 E Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 Two or more fomily - Enter 19 n 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 - hriter number
5 ❑ Wrecking (If multifamily residential, of units ------- - -i 22 Service station, repair garage
enter number of units in building in 15 L Garage 23 Hospital, institutional
Part D, 13)
16 Car ort //%% 24� � Office, bank, professional
6 n Moving (relocation) 17 � Other - Specify f`''r 25 Public utility
7 Foundation only
26 L_� School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 Private (individual, corporation, 28 Tanks, towers
nonprofit institution, etc.) 29 n 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
a. Electrical....................... C+
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 n 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 n Public or private company 50. Total land ores, sq. ft. ,.........
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........................
36 Oil conditioning? _ L. RESIDENTIAL BUILDINGS ONLY
37 "j Electricity 44 n Yes 45 !r No
53. Number of bedrooms..............
38 Coal
39 n Other - Specify Will there be an elevators Full..........
_ 54. Number of
46 �_ Yes 47 '��� No bathrooms
Portial.......
DEPT!OF IWILDING INSPECTIONS BUILDING z':-) ~�
212 Main Street ate -�`�
Northampton, MA 01060 PERMIT
3 - 10 VALIDATION
DATE March 2, 19 88 PERMIT NO. 93
APPLICANT Erank Pri ng,l P ADDRESS 565 Coles Meadow Rd. Owner
(NO.) (STREET) (CONTR'! LICENSE)OF
PERMIT TO New Building (_) STORY Utility Shed NUM ER UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
565 Coles Meadow Roaa ZONING RR
AT (LOCATION) DISTRICT
(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 a storage shed
AREA OR 96 sq. ft. 500,00 PERMIT 1 0.00
VOLUME ESTIMATED COST $ FEE s
(CUBIC/SQUARE FEET)
OWNER Same as Applicant ,y
ADDRESS
Same as Applicant' s BYILDIND ✓'�'^
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY • PINK - ASSESSORS COPY p*NT- P
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