29-495 (2) ZONING •
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
IX. SITE OR PLOT
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w-
NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
�1 o h N cad a e4 ��l�n cr2 d ag-9dZ
caner or
e s see /Or's C �� 0"I G
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
ak this application as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
ignotu of applicoW I Address Application date
a.�
C_JDO 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 Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obtained 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 -> FOR DEPARTMENT USE ONLY
>
Permit number ��
Building Use Group
Permit issued 1999
Building Fire Grading
Permit Fee $ e tt-
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $ �, .�-
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�• •� MASSACHUSETTS
3 ! OFFICE of the INSPECTOR of BUILDINGS
Page Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. 0
I•
ZONING
AT (LOCATION) ' jbs �i/�it/
DISTRICT
LOCATION (NO.) �� STREET) a.�
OF BETWEEN- -f-��-.r��.6.A=k Dn*,/K AND�_?Ie#VW0Qyl!'
BUILDING CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
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 ❑1 New building Residential Nonresidential
2 ' Addition(If residential, enter number 12 ❑ One family 18 ❑ Amusement, recreational
in new housing ur}CZed, if any, 13 ❑ Two or more fami ly — Enter 19 ❑] Church, other religious
in Part D, 13) /ab number of units— — —
3 ❑� Alteration (See 2 above) 20❑ Industrial
14 ❑ Transient hotel, motel, 21 Parking garage
4❑j Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (11 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)
17X Other — SpeciJy Rd '\ 25 ❑ Public utility
7 ❑� Foundation only
26 ❑ School, library, other educational
B. OWN RSHIP 27 ❑ Stores, mercantile
8 Private (individual, corporation, 28
Tanks, towers
nonprofit institution, etc.) 29❑ Other - Specify
9 ❑j 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,,,,•,,,•,,•.,,• 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 F—] Masonry (wall bearing) 40 Public or private company Number of stories..............
31 Cl Wood frame 41 7] Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior
32 g Structural steel dimensions .....................
33E] Reinforced concrete H. TYPE OF WATER SUPPLY
34 E] Other — Specify 42 V 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 E] Gas Will there be central air S2. Outdoors........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 CJ Electricity 44 [-] N
4o
Y e s 5 '', 53. Number of bedrooms..............
38 ❑ Coal
39 C-] Other — Specify Will there be an elevator? Full..........
54. Number of
46 ] Yes 47 X No bathrooms
Partial.......
DEPT. OF BUILDING INSPECTIONS BUILDING �O
212 Main Street 0<
Northampton, MA 01060 PERMIT <a
'• - VALIDATION
sawl DATE 19 PERMIT NO.
y; -?7,7 7
APPLICANT - ADDRESS
(NO.) (STREET) (CONTR'S LICENSE)
4
NUMBER OF
PERMIT TO STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
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: ('0 ,Is
AREA OR _. PERMIT
VOLUME ESTIMATED COST $ FEE
(CUBIC/SQUARE FEET) t?'•• "
OWNER 1 n (
BUILDING DEPT.
ADDRESS ` ..• G, BY
WHITE FILE COPY GREEN - FIELD COPY CANARY - APPLICANT COPY ■ PINK - ASSESSORS COPY p411-t P
p , DEPT. OF BUILDING INSPECTIONS
BUILDING ;°
212 Main Street 0-C
Northampton, MA 01060 PERMIT <b
29 - 495 op VALIDATION
88
DATE May 26 9 pERM1T NO. 363
APPLICANT John Glenowicz ADDRESS yan ad owner
(NO.) (STREET) (CQNTR'S LICENSE)
Addition Pool NUMBER OF
PERMIT TO (�) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 405 Ryan Road Florence ZONING )IRA
(NO.) (STREET) OISTR ICT
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,..,,,,. i to install in-ground pool .
AREA OR 2000.00 00 PERMIT 10.00
VOLUME ESTIMATED COST $ FEE $
(CUBIC/SQUARE FEET) dd
OWNER John Glenowicz BUILDING DEPT. ~
ADDRESS
405 Ryan Road Florence BY �
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY P 0.-CP