17C-220 (28) VIII. 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 r
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
Owner or I i l`IjF "` i. �: f t `
Lessee
Bui Ider's
2. (� 1 l I` {. i,. {; v I l l j, License No.
Contractor
I
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.
Si ature f a lic nt Address
9n, o P Application date
+ � l
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 $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Permit or Approval Check Obtai ed 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 j^ FOR DEPARTMENT USE ONLY
Permit number r� Q
Building use Group
Permit issued
Building T— Fire Grading
Permit Fee
Live Loading
Certificate of Occupancy $ Occupancy Load
Approk
Drain Tile $
L/--
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
r
$ e OFFICE of the INSPECTOR of BUILDINGS
IV T
Page 17C- Plot 7,-zc.1 APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. C)
ZONING
AT (LOCATION) �� t' 7 'f `C ') DISTRIC
LOCATION (NO.) — (STREE I
OF BETWEEN / AND •( f
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D X
A. TYPE OF IMPROVEMENT D. PROPOSED USE – For"Wrecking" most recent use m
m
i D New building Residential Nonresidential
2 ' Addition(1 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– – – – --)P- 20 Industrial
3 Alteration (See 2 above)
14 Transient hotel, motel, 21 F-1 Parking garage
4 El Repair, replacement or dormitory – Enter number
5 ❑ Wrecking (If multifamily residential, of units ––––––– – -- 22 L] Service station, repair garage
enter number of units in building to 15 n Garage 23 Hospital, institutional
Part D, 13)
16 Carport 24 n Office, bank, professional
6 Moving (relocation)
17 Other – Sped/y 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 n Other – Specif.
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................ X40 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.).............
it. TOTAL COST OF IMPROVEMENT Is /
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 W.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
30 Masonry (wall bearing) 40 N- Public or private company 48. Number of stories................
31 Wood frame 41 El Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 Structural steel dimensions ..................... L'
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
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ......................
35 Gas Will there be central air 52. Outdoors........................
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 j Electricity 44 F- Yes 45 — No
53. Number of bedrooms..............
38 Coal
39 Other – Specify Will there be an elevators Full..........
54. Number of
46 Yes 47 D No bathrooms Partial.,.....
DEPT. OF BUILDING INSPECTIONS Z
� �
BUILDING .
11 cC
212 Main Street z<
Northampton, MA 01060 PERMIT <a
17C - 220
VALIDATION
DATE May 2 19 88 PERMIT NO. 262
APPLICANT Martin Sullivan ADDRESS 12 Fort Hill Rd. Ha�cGl�q>�ci l Ie 013471
(NO.) (STREET) Tom» (CONTR'S LICENSE)
Addition Restaurant NUMBER OF
PERMIT TO (_) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
17 No. Maple St. ZONING GB
AT (LOCATION) DISTRICT
(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 to build addition of a bathroom.
AREA VOLUME ESTIMATED COST $ 1400-00 PERMIT
CUBIC/SO DARE FEET) E 1 0.00
(
OWNER
Cottage Kitchen Inc.
17 NU. Mdpfe St.
ADDRESS BYILD
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY p0" I'