17A-081 Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
IX. SITE OR PLOT PLAN For Applicant Use
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IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
1. 6'o�i�
Owner or
Lessee
Bui Ider'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.
Signature f applicant Address ' Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B
Fee Started y Approved y Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL Is
OTHER is
V1. 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 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 I FOR DEPARTMENT USE ONLY
Permit number tJ
Building Use Group
Permit issued 19
Building �p Fire Grading
Permit Fee Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
\ j � -'cam' 2•;
TITLE
CITY OF NORTHAMPTON
�, MASSACHUSETTS
$ OFFICE of th 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
I
/// ZONING
1• AT (LOCATION) �• � �i4 l� ���� DISTRICT
LOCATION )"O•) 57RE ET)
OF BETWEEN AND
BUILDING ccaoss STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
11. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
--f
1 New building Res'dential Nonresidential
2 Addition(if residential', enter number 12 One family 18 Amusement, recreational
of new bousing units'added, if any,
in Part D, 13) 13 Two or more fomily — 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 — Enter number
5 ❑ Wrecking (It multifamily residential, of units ——————— — -- 22 Service station, repair garage
enter number of unit_' in building in 15 Garage 23 Hospital, institutional
Part D, 13) 16 Carport
24 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................
U0 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......... .............
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..............
49. Total square feet of floor area,
31 Wood frame 41 Private (septic tank, etc.) J
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 area, 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 [_1 Yes 45 '._,-4; No 53. Number of bedrooms..............
38 Coal
39 n Other — Specify Will -here be an elevators Full..........
54. Number of
46 P Yes 47 N No bathrooms
Partial.......
Cityof Northam p ton REQUIRED INSPECTIONS
$ I . Footings and Walls
BUILDING DEPARTMENT 2 . Structural Components in
Place
3 . Complete Building
No. 14 Office of the Building Inspector
Date January 4. 19 90
B,U1 DING P RMIT
i
THIS MAY CERTIFY THAT Gordon Matthews Insp. on Site — Foundations
has permission to construct an 6' X 8' storage shed Insp. of Plumbing — Rough
situated on 31 Carolyn Street Insp. of Plumbing — Finish
provided that the person accepting this permit shall in every re-
Insp. of Wiring — Rough
spect conform to the terms of the application on file in this office,
and to the provisions of the Statutes and the Ordinances relating Insp. of Wiring — Finish
to the Construction, Maintenance and Inspection of Buildings in Insp. of Health (Septic Tanks)
the City of Northampton. Any violation of any of the terms above
noted is an immediate revocation of this permit. Expires six Building Insp. — Rough
months from date.
Building Insp. — Finish
Note: A certificate of occupancy will be issued by this office upon
return of this card signed by the Plumbing, Wiring and Building Smoke Detectors (Fire Dept.)
Inspectors. Gas Inspection
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLAC ON PREMISES
Certificate of Occupancy
Building Inspector -_