06-017 (10) 19
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Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN For Applicant Use
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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.
1.Owner or 9
Lessee
2. Builder's
Contractor License No.
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 W R I T E BELOW T H I S L I N E
V. PLAN REVIEW RECORD For office use
Plan Review Date Plans Date Plans
Plans Review Required Check Fee Started By Approved By Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date D
Permit or Approval Check Obta i ned Number By Permit or Approval Checkj Obtai ate ned 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 11 JJ FOR DEPARTMENT USE ONLY
Permit number
Building 61 Use Group
Permit issued 19
Building Fire Grading
Permit Fee Live Loading
Certificate of Occupancy $ Occupancy Load
Drain Tile $ Appro d by:
,roved
Plan Review Fee
TITLE—'-
CITY OF NORTHAMPTON
MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
JY 1
Page— Plot F1 APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, Ill, IV, and IX. 0
/,.�t� ZONING
I• AT (LOCATION) �`'�` y r - f- '� �^'`.' +'F1.,< DISTRICT
LOCATION (NO.) (STREET)
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 ;10
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use rn
rn
1 ❑ New building R i ential Nonresidential
2❑ Addition(If residential, enter number 12 One family 18 ❑ Amusement, recreational
of new housing units added, if any, iL��
XAlterotion n Part D, 13) 13 Two or more family — Enter 19 ❑ Church, other religious
number of units— — — — --� 20 ❑ Industrial
(See 2 above) 14 Transient hotel, motel,❑ 21 L � Porking garage
epair, replacement or dormitory — Enter number
5 ❑ Wrecking (If 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 ort Car 24�_� Office, bank, professional
6 ❑ Moving (relocation) ❑ p
17 ❑ Other — Specify fd t' 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
1 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 $ 1"
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................ �• i
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
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 L] Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37E_] Electricity 44 Yes 45 No
53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — .Specify Will there be an elevator° Full..........
54. Number of
46 ❑ ��Yes 47 I No bathrooms
Partial.......
t �
DEPT. OF BUILDING INSPECTIONS BUILDING ZD
212 Main Street 04
I IL
Northampton, MA 01060 PERMIT
6 - 17 VALIDATION
DATE j11nP 7, 19 A 9 PERMIT NO. 366
APPLICANT low 01donnel1 ADDRESS H�(�P�w7llj� d_� I pods
INO.) {yTREE T) (C ONTR'b LICENSE)
ne Fami 1 NUMBER of
PERMIT TO (_I STORY- n v DWELLING UNITS
( lift IM R M NT) N0. TPROPObEO USE)
AT (LOCATION) 357 Hay envy e . , Leeds D STA CT
(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; ermit for the installation of an in-ground swimming pool 181X361 must be surrounded
by a 41 fence with a self locking gate. Electrical permit is also require
VOLUME 648 $q. ft. ESTIMATED COST $ 16,000.00 PERMIT .� 10.00
(CUBIC/SQUARE FEET)
OWNER Lorraine & William Ryan
ADDRESS 357 Haydenv i l l e Rd. , Leeds BYILD
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY P0NfP
f
04C
��lssaxcltnaetls
m R MENT OF IIUILDINGANSPECTIONS ! o
INSPECTOR 212 Maij� Street ' Municipal Building
Northampton, Mass,` 01060
REQUEST FOR PERMISSION TO VIEW`
RECORDS OR HAVE COPIES OF DOCUMENTS
MADE.
DATE lU 17-9d
FILE ADDRESS: Sew p, ?cclne PAGE: PLOT:
� ^ P*`� ti�AVr'S�tt► /55C/ Mir 4 y/;
.NAME: =LRS �w94n� Cv5b)a ADDRESS & PHONE it: 6911)
— -- i -7u4'-02io 3
UNDER MASSACHUSETTS GENERAL LAWS WE HAVE THE RIGHT TO MEET THE ABOVE REQUEST WITHIN TEN ( 10
DAYS OF THE ABOVE LISTED"DATE.
I