03-010 (4) FRONT VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
{
SIDE YARD 'to' SIDE
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
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NOTES and Data — (For department use)
41 214,1
Inspection Dote
. i
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or
r
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.
ignature applic t Address Application date
DO 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 $
V1. 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
Bui(ding- Use Group
Permit issued 19
Building Fire Grading
Permit Fee $ t
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $ t
CITY OF NORTHAMPTON
�• '- MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page— 3 Plot rL1 APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT - Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING
I• AT (LOCATION) DISTRICT
LOCATION (NO.) (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,
Two or more family — Enter 19 Church, other religious
in Part D, ]3) 13
number of units— — — — •-)� 20 ❑ Industrial
3 ❑ Alteration (See 2 above)
14 ❑ Transient hotel, motel, 21 ❑ parking garage
4 Repair, replacement or dormitory — Enter number
Of 5 Wrecking (If residential, o units ——————— — --� 22 ❑ Service station, repair garage
L❑
enter number of units in building in 15,X Garage 23 ❑� Hospital, institutional
Part D, 13)
16 ❑ Carport •� 24 ❑ Office, bank, professional
6 ❑ Moving (relocation) 17� 4 > ❑
n -.pwrr►r 25 Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
28 ❑ Tanks, towers
8 �Private (individual, corporation, Specify
Other — S
nonprofit institution, etc.) 29 ❑ p fy
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................ 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 L❑ Masonry (wall bearing) 40 ❑ Public or private company 48. Number of stories..............
31 Wood frame 41 LVPrivate (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on xteno
32 ❑ Structural steel dimensions �.. .. .lJ.... LLJ
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other — Specify 42 ❑ Public or private company 50. Total land area, sq. ft. ...........
43X 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 j Electricity 44 �
❑ Yes 45 � - No 53. Number of bedrooms..............
38 Coal � k
39 Other — Spe iJy. Will there be an elevator Full.........
54. Nurnber of
46 ❑ Yes 47 o bathrooms
Partial......
Department of Building Inspections
212 Main Street BUILDING '
Northampton, M 040 O< $40.00
I PERMIT
(�yJ Qa
" 3 T� � + VALIDATION
DATE April 19, 19 83 PERMIT NO. 170
APPLICANT Frank P. Pringle ADDRESS Coles Meadow Road
(NO.) (STREET) (CONTR'S LICENSEI
to construct additio NUMBER OF
PERMIT TO n(�) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 565 Coles Meadow Road ZONING CT RR
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE 30 FT. WIDE BY 40 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: n
AREA OR VOLUME 30' X 40� ESTIMATED COST $ 10,000.00 FEEMIT 40.00
(CUBIC/SQUARE FEET)
OWNER Frank P. Pringle r
BUILD G 2
ADDRESS 565 Co]PC Mpadnw Rnad BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY