05-039 (2) Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YARD
SIXE YARD SIDE YARD
REAR YARD
--W
IX. SITE OR PLOT PLAN For Applicant Use i
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NOTES and Data — (For department use)
Jo
I All
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1
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C �Y
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IV. IDENTIFICATION — To be completed by all applicants
' r Name Mailing address — Number, street, city, and State ZIP code Tel. No.
1. J
Ow U ct`t,k th < � r' K
ner or ,
Lessee `w 11
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.
Signature of 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 By Date Plans By Notes
Fee Started Approved
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL Is
OTHER Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Permit or Approval Check Obtained Number By Permit or Approval Check Obttaitned 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
V11. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued 19
Building
Fire Grading
Permit Fee $ y�6 a) Live Loading
Certificate of Occupancy $ �F. ccuponcy Load
Appro d j
Drain Tile
Plan Review Fee
TITLE
r CITY OF NORTHAMPTON
MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page t_ Plot — APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, III, IV, and IX. O
( eft ZONING Irlp
I• AT (LOCATION)
'�V \ �tr���(, C`..{.� {zA t (��, 4� DISTRICT
LOCATION (NO•) (STREET)
�
OF BETWEEN �'\.�.O ��1.. � � fLA AND 2)1
OF
BUILDING (CROSS 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 D New building Residential Nonresidential
2'Rj Addition(If residential, enter number 12 KOne family 18 Amusement, recreational
of new bousing units added, if any,
in Part D, 13) 13 � Two or more family — Enter 19 n Church, other religious
number of units— — — — --). 20 Industrial
30 Alteration (See 2 above)
14 Transient hotel, motel,
4 Repair, replacement —" 21 Parking garage
p p or dormitory — Inter number
5 n Wrecking (11 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 L] Moving (relocation)
17 Other — Specify_" 25 Public utility
7 D Foundation only
26 School, library, other educational
B. OWNERSHIP gC �'C"� V� if c h 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 (()Writ 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 ....................... y'
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT Is Ll (D
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 1V.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
30 L_._J 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 �J Reinforced concrete H. TYPE OF WATER SUPPLY �t
34 Other — Specify 42 Public or private company 50. Total land area, sq. ft. ........... IS <iC �r-1
C_
43 Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 L Gas Will there be central air 52. Outdoors........................
—I conditioning?
36 L_ _I Oil L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 Yes 45 No 53. Number of bedrooms..............
38 Coal
39 Other — Speedy Will there be an elevator Full..........
54. Number of
46 [ 1 Yes 47 No bathrooms
Partial......
5 -59 i�-'c'/Z"sr'
DEPT. OF BUILDING INSPECTIONS gU I LDI NG Z° f
212 Main Street o< � 1 � t
Northampton, MA 01060 PERMIT <a
5 - 39 VALIDATION
DATE Augus! Q t ER IT NO. 503 -
APPLICANT Judith Leeds ADDRESS e f�oad"
(NQ.) (STREET) (CONTR'S LICENSE)OF
Addition One Family DWELLR
PERMIT TO STORY
ING UNITS
(_)
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION)
551 Kennedy Road, Leeds DIISTR CT
(N0.) (STREET)
BETWEEN AND
(CROSS STREET) ([ROES 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 addition of a screened in porch
VOLUME 12' X 16' = 192 ESTIMATED COST 4,000.00 FEEMIT �t 16. 0
(CUBIC/SQUARE FEET) % /t
OWNER Same a-, AiDpl(can
BUILDIN
ADDRESS Same_ a-, Anolican •'s BY `
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK -/ASSESSORS COPY I, NP
SIEMENS