17A-066 (3) -Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT
SIDE YARD SIDE YARD
REAR YARD
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
l�Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or ��" • ���
Lessee 1' • 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.
Signat
ire of applicant -� Address Application date
.r
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 Date
PP 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
Permit issued !'�''�" � Iq
Use Group
Building Fire Grading
Permit Fee $ f• u
Live Loading
Certificate of Occupancy $ Occupancy Load
A oved by:
Drain Tile $ '`)
Plan Review Fee $
TITLE
f CITY OF NORTHAMPTON '—tf•
�. '�'.� MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
,�t
Page 7 Plot 66 APPLICATION FOR
1
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. 0
2 �� ZONING
DISTRICT
I• AT (LOCATION) (STREET)
LOCATION `N 0.)
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
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— — — — --0- 20❑ Industrial
3 ❑ Alteration (See 2 above)
14 ❑ Transient hotel, motel, 21 ❑ parking garage
4❑ Repair, replacement or dormitory — Enter number
5 El Wrecking (1f multifamily residential, of units ——————— — 22 ❑ Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional
Part D, 13) 24❑ Office, bank, professional
6 Moving (relocation) 16 ❑ Carport
❑ 17 ❑ Other — Specify 25❑ Public utility
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP 27❑ Stores, mercantile
8-z 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,,,,,,,,,,,,,,,, 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 $ C, jx
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 ❑ Public or private company
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
Public or private company 50. Total land area, sq. ft. ...........
42
34 ❑ Other — Specify ❑ p
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 C Electricity 44 [_] Yes 45 ❑ No 53. Number of bedrooms..............
38 Coal
39 L I Other — Specify Will there be an elevotor? 54. Number of Full..........
46 Yes 47 '_1 No bathrooms
�-- Partial.......
Department of Building Inspections
212 Maid Street BUILDING z° ( ` G
Northampton, Ma. 01060 PERMIT �(L
PERMIT/ Iv!
17A — 66 VALIDATION
DATE February 15.._19 $3 PERMIT NO. 74
APPLICANT Cecil R Jacobs ADDRESS RQynnIds Aluminum 030739
(NQ.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Solar Panels (_^_) STORY SA1 Ar PAnejg DWELLING UNITS 1
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) 256 Bridge Rnad DISTRICT TTRA
(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
AREA OR VOLUME ESTIMATED COST $ 5700.00 FEE
(CUBIC/SQUARE FEET)
c
OWNER Wal tar R Boygx,r_TJ • BUILDI
ADDRESS 756 Azldge Rd., Noz r BY
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