35-160 (4) Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR I
NOTES
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cauturmumull:
NOTES and Data — (For department use)
Mw
IV, IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, 51reet, city, and Slate ZIP code Tel. No.
C A4 2 7;7f A, GicG D sic-c 5'7s
owns, or
Lessee
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 a plicant 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 B Notes
Fee Started Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number B Permit or Approval Ch Date Number B
Obtained y pp Check Obtained N b y
BOILER PLUMBING
CURB OR SIDEWALK CUT ROOFING
ELEVATOR SEWER
ELECTRICAL j SIGN OR BILLBOARD
FURNACE STREET GRADES
GRADING USE OF PUBLIC AREAS
OIL BURNER WRECKING
OTHER OTHER
11. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number 17
Bui(ding. i
Use Group
Permit issued 19
q
Building Fire Grading
Permit Fee $ C1,06
Live Loading
Certificate of Occupancy $ Occupancy Load
AM by:
Drain Tile $ ,
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�. MASSACHUSETTS
e OFFICE of the INSPECTOR of BUILDINGS
Page Plot l6,
g APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. 0
ZONING
DISTRICT
(• AT (LOCATION) ��j TREET)
LOCATION (NO.
OF BETWEEN Gt°'rY tc,`6e 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 ❑ Two or more family - Enter 19 ❑ Church, other religious
number of units- - - - --jo- 20❑ Industrial
3 ❑ Alteration (See 2 above)
14 ❑ Transient hotel, motel, 21 ❑ Porking garage
4 ❑ Repair, replacement or dormitory - Enter number
5 F-1 Wrecking (If multifamily residential, of units ------- - -i 22 ❑ Service station, repair garage
enter number of units in building in 15 Garage 23 ❑ Hospital, institutional
Part D, 13) 24❑ Office, bank, professional
6 ❑ Moving (relocation) 16 ❑ Carport
17 ❑ Other - Specify 25 ❑ Public utility
7 ❑ Foundation only
,, `1 ,(� 26 ❑ School, library, other educationol
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
_ processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,...•••••....... �GrC.f 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 $
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 ❑ 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 L.(2 34 F-1 Other - Specify 42 ❑ Public or private company 50. Total land area, sq. ft. ........... 7J-CCL1
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL 1. TYPE OF MECHANICAL 51. Enclosed ......................
35 ❑ Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 ❑ Yes 45 No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other - Specify Will there be an elevator? 54. Number of Full..........
46 ❑ Yes 47 ❑ No bathrooms
Partial.......
DEPT.—Of B6LDING INSPECTIONS BUILDING
212 Main Street 0
I IL
Northampton, MA 01060 PERMIT
35 - 160 VALIDATION
DATE May 19 19 85 PERMIT NO. 219
APPLICANT Richard Lamica ADDRESS 779 Ravn Ran Fl nrPn�Q -L10M
(NO.) (S REET) (CONTR'S LICENSE)
New Building UMBER OF
PERMIT TO g (`) STORY- GBrae DWELLING UNITS
(TYPE OF IMPROVEMENT) yNO. (PROPOSEO USE)
AT (LOCATION) 779 Ryan Road ZONING 2R
(NO.) (STREET) DISTRICT
BETWEEN AND
(CROSS STREET) (CROSS STREETI
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE 24 FT. WIDE BY 24 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
for (TYPE)
REMARKS; permit:NW the construction of a new c1Ptachpd garggA
AREA OR VOLUME 576 SCI. ft. ESTIMATED COST � 500.00 FEEMIT 10.00
(CUBIC/SQUARE FEET)
OWNER Same as Applicant \
Same 13U
as Applicant P,:"T� icant BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY ■ PINK - A ESSORS COPY p-OF