29-369 VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
IX. SITE OR PLOT PLAN For Applicant Use
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NOTES and Data — (For department use)
now
i
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
a
,
f _ i
Owner 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 applicaqt ` _ Address L Application date
i
DO N`OT 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 $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number By Permit or Approval Check Date Number B
Obtained Obtained 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 c
Building Use Group
Permit issued 19��
Building Fire Grading
Permit Fee $ Live Loading
Certificate of Occupancy $ Occupancy Load
$ Approved bv
Drain Tile
to
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�. .$ MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
AY T
Page Plot - T APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
I• AT (LOCATION) �� ' } ����! i�`� ZONING DISTRICT
LOCATION NO.) (STREET)
OF BETWEEN G 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 rn
rn
1 :` New building Residential Nonresidential
2 ❑ Addition([/ residential, enter number 12❑ One fomi ly 18 ❑j 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- - - - i 20 Industrial
3 ❑ Alteration (See 2 above)
14 Transient hotel, motel, 21
Parking garage
4 ❑ Repair, replacement or dormitory - Fnter number
5 ❑ Wrecking (1f multi family residential, of units ------- - -i 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 - Specify
�• i7 L' '�? 25 ❑� Public utility
��
7 ❑ Foundation only
26 E] 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,,,,,,,,,,,,,,,
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 (elevotor, 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
48. Number of stories................
30 F-1 Masonry (wall bearing) 40 ❑ Public or private company
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
34❑ Other - Specify 42 F—] Public or private company 50. Total land ores, 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 Electricity 44 ❑ Yes 45 I No 53. Number of bedrooms.............
38 ❑ Coal
39❑ Other - Specify Will there be an elevators Full..........
- 54. Number of
46 [—] Yes 47 D No bathrooms
Partial.......
DEP-f!"OftVILDING INSPECTIONS BUILDING z° t ��
+ ! 212 Main Street oa
' Northampton, MA 01060 PERMIT
29 - 369 p VALIDATION
DATE May 11 , (g 87 PERMIT NO. 271
APPLICANT Frank Pruzynski ADDRESS 45 Austin Cir. Owner
(NO.) (STREET) (CONTR•S LICENSE)
NUM ER OF
PERMIT TO
New Building (_) STORY Storage Shed DWELL NG UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
45 Austin Cir. ZONING CT URA
AT (LOCATION)
(NO.) (STREET) DISTR
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK -SIZE
BUILDING IS TO BE 10 FT. WIDE BY FT. LONG BY _FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: permit for the construction of a--new storage sh cl
AREA OR 90 sq. ft. 300.00 PERMIT 10.00
VOLUME ESTIMATED COST $- FEE .
(CUBIC/SQUARE FEET) /1
Same as Applicant (/
OWNER BU
ADDRESS BY 9
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY ■ PINK ^ ASSESSORS COPY p)NT p