17C-160 (5) Vill. ZONING PLAN EXAMINERS NOTES
FRONT DISTRICT
SIDE YARD SIDE YARD
REAR YARD
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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. �..y f�'rt' !'_i y
Owner or
Lessee
Builder's
`L. i1 License No.
Contractor t>J✓
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.
Signattire.of applicant Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Dote P y Ions B Date Plans By Notes
Fee Started Approved
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL Is
OTHER Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Dare Number By Permit or Approval Check Dote Number B
Obtained 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 FOR DEPARTMENT USE ONLY
Permit number
BUI Iding- N Use Group
Permit issued 19 �`�
Building ��.. Fire Grading
Permit Fee $ � {`
Live Loading
Certificate of Occupancy $ Occupancy Load
Apprgve. .by-
Drain Tile
Plan Review Fee
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
Page i 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
L ZONING
1. AT (LOCATION) ��� DISTRICT \J
LOCATION (N0.) (STREET)
OF BETWEEN AND
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 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 C❑ Two or more family — Enter 19 ❑ Church, other religious
3 Alteration (See 2 above)
number of units— — — — 20 ❑ Industrial
❑ _
14 ❑ Transient hotel, motel, 21 L� Parking garage
4 ❑ Repair, 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 ❑1 Hospital, institutional
Part D, 13) 16 ❑
6 ❑ Moving (relocation) Carport 24❑ Office, bank, professional
7 ❑ Foundation only 17 ❑ Other — Specify 25 �❑ Public utility
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8 rZ Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 ❑ Other — Specify
90 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•,••••••,•,••••• C'%'!.) 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....................... 1 " ✓
b. Plumbing .....................
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT I$I0 c(,! ?,%,�III. SELECTED CHARACTERISTICS OF BUILDING — For building and additions, complete Parts E — L;
for wrecking, complete only Part J, for all others skip to W.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS r
30❑ Masonry (wall bearing) 40 ❑ Public or private company 48. Number of stories............ ^
Total square feet of floor area,
31 ❑ Wood frame 41 ❑ Privatee,(septic tank, etc.) 49. all floors, based on exterior
32 ❑ Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY j7)t)
34 E-1 Other — Specify 42 Public or private company 50. Total land area, sq. ft. ........... �VL
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 es 7 No
[--] Y 45 [� 53. Number of bedrooms...............
38 ❑ Coal
39 ❑ Other — Specify Will there be an e'evator? Full..........
54. Number of
46 [_1 _Yes 47 1 No bathrooms Partial........
Department of Building`Inspections
212 Main Street BUILDING ZO
Northampton, Mass. 01060 O< $40.00
1 IL
PERMIT
17C - 160
VALIDATION
DATE August 25, 19 83 PERMIT NO. 422 o3�ggy
APPLICANT Robert Keyes ADDRESS 9 Keyes Street xM 1
(N0.) (STREET) (CONTR'S LICENSE)
New Building Produce Stand NUMBER OF
PERMIT TO I_) STORY DWELLING UNITS _
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
9 Keyes Street ZONING GB
AT (LOCATION) DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE 30 FT. WIDE BY 25 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: year round produce stand for wholesale and retail sale of agriculture or farm products
& employ one sales person
AREA OR 750 sq. ft• 10,000 00 PERMIT 40.00
VOLUME ESTIMATED COST • FEE
(CUBIC/SQUARE FEET)
OWNER Robert Keyes BuIL
ADDRESS 29 Keyes Street, Florence BY W `f
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY