23D-155 (3) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
IX. SITE OR PLOT PLAN For Applicant Use
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NOTES and Data — (For department use)
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IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and Stag ZIP code Tel. No.
n
Owner or
Lessee
Bui r
2. License No. JY4-31'3`�
Contractor
0 i44 is
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 ddress Application date
D NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans By Notes
Fee Started y Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date D
Permit or Approval Check Obtained Number By Permit or Approval Check Obtta t ed 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 Use Group
Permit issued x.53 19�
Building +�� Fire Grading
Permit Fee $
�— Live Loading
Certificate of Occupancy $ Occupancy Load
A ro ed by:
Drain Tile $
Plan Review Fee $ 4
J
TITLE
` CITY OF NORTHAMPTON
�. MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page
c't Plot / 5—,57 APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. �r O
ZONING j '1
I• AT (LOCATION) ! ��(� -�YC..i DISTRICT t/)
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
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use M
M
1 ❑ New building Residential Nonresidential
2 �JCddition(If residential, enter number 12 One family 18 F-1 Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 Two or more family — Enter 19 n Church, other religious
number of units- - — — -� 20 n Industrial
3 Alteration (See 2 above)
14 Transient hotel, motel, 21 Parking garage
4 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 in 15 Garage 23 Hospital, institutional
Part D, 13) ❑16 Carport 24 r"—
�� Office, bank, professional
6 n Moving (relocation)
17 Other — SpeciJy 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 D 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,,,,,,,,,,,,,,,, C21 000 school, secondary school, college, parochial school, parking garage for.
department store, rental office building, office building at industrial plant.
7'o be installed but not included If use of existing building is being change enter proposed use.
in the above cost
a. Electrical.......................
b. Plumbing .......................
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $
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...............
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 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 Gas Will there be central air 52. Outdoors........................
36 Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 C Electricity 44 [7] Yes 45 � No 53. Number of bedrooms..............
38 Coal
39 Other — Specify Will there be an eievator7'[J Full..........
�
� 54. Number of
46 Yes 47 No bathrooms partial.......
DEPT. OF BUILDING INSPECTIONS BUILDING ZO
212 Main Street o< Il a '
Northampton, MA 01060 PERMIT
23D - 155 p VALIDATION
June 2, �g o7 PE MIT NO. 332
DATE 1 ` Lee 2
APPLICANT D.A. Williams ADDRESS a er tree ,
(NO.) (STREET) (CONTR•S LICENSE)
One Family NUMBER OF
PERMIT TO Acid i t i on (_) STORY y DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
15 Maplewood Terrace ZONING URB
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: 09KMKI-K permit for the addition of a sun room and study area
AREA OR 512 sq. ft. 000.00 PERMIT $ 112.00
VOLUME ESTIMATED COST 28 FEE
(CUBIC/SQUARE FEET)
Dr. David Jackson
OWNER BUI
ADDRESS 2 Maplewood Terrace BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK ASSESSORS COPY pop