17A-097 (4) Vill. ZONING PLAN EXAMINERS NOTES
FRONT YARD
SIDE YARD SIDE YARD
IX. SITE OR •
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name (/M�'aiilling address — Number, street, city, any! State ey ZIP code Tee/ll.. No.
Owner or �..._� °" CSC
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 applicant ` Address Application d
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plan Review Date Plans Date Plans
Plans Review Required Check Fee Started By Approved By Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Approval Check Date um Approval Check Date
Permit or A umer
pp Number B y Permit or A Obtained pp Number By
y
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 rr----��
Building --�-'� / FOR DEPARTMENT USE ONLY
Permit number r /
Building Use Group
Permit issued 19�
Building Fire Grading
Permit Fee $ Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by-
Drain Tile $ R'�"
t
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�• •e MASSACHUSETTS
r
$ e OFFICE of the INSPECTOR of BUILDINGS
Page / ? A Plot TT APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. o
I• �� �`�i�'"�/ Rr�'Tefrr�G� ZONING
AT (LOCATION)
DISTRICT-W �a
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — DN+
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
M
1 New building Residential Nonresidential
2 N Addition(If residential, enter number 12 One family 18 ❑ Amusement, recreational
of new housing units added, if any, y - Enter 19 religious
Two or more family Church, other reli
in Part D, 13) 1 ❑ 9
number of unit`s- - - - -� 20 Industrial
3 F-1 Alteration (See 2 above) 14 ❑ Transient hotel, motel, ❑
4 ❑ Repair, replacement 21 ❑ Parking garage
p P 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 ❑ Hospital, institutional
Part D, 13)
16 ❑ Carport 24❑ Office, bank, professional
6 ❑ Moving (relocation)
17❑ Other - Speci/y 25❑ Public utility
7 F-1 Foundation only
26❑ School, library, other educational
B. OWNERSHIP lJf�'�1(/ 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,,,,,,,,•••,•._. i 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.)............ �y
11. 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 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 frome 41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area, /
all floors, based on exterior
32 ❑ Structural steel dimensions ..................... `(1
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 F-1 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 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
Full..........
54. Number of
46 ❑ Yes 47❑ No bathrooms Partial........
�.�„� .a, � r� -,�.-r r,�� �..�s„�-s�n,�-. .,�,-� m, r „�, ,�.,.....,,....
�,
DEPT. OFIUILDING INSPECTIONS BUILDING z'- /-1 -�.._.
+ ! 212 Main Street $
Northampton, MA 01060 PERMIT
17A - 97 VALIDATION
DATE July 9, g XNXX 86 PERMIT NO. 367
APPLICANT Eileen Hayes ADDRESS U"ran view St. Owner
(NO.1 (STREET) (CONTR'S LICENSE)
New Building Storage Shed NUMBER of
PERMIT TO g �_) STORY g DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING 37 Grandview Terr. DIISTR CT URA AT (LOCATION)
(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: N&WM permit for the construction of a new aux. building
AREA OR 80 sq. ft. ESTIMATED COST .$ 780 PERMIT $ 10. 0
VOLUME
(CUBIC/SQUARE FEET)
OWNER Same as Applicant /
I
ADDRESS
ame as Applicant's BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY PQP