35-021 (7) VIII. ZONING PLAN EX-AMINERS NOTES
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)
0 X"
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
Owner or
Lessee
J
`� QL� C l Builder's
2.
� � (��� � �� License No.
Contractor
3.
Architect or ' ��1
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.
Sign a of plic 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 is
V1. 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
Building Use Group
Permit issued Zs 19 �6
Building 64,3.6o/ Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
A by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
10 MASSACHUSETTS
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. o
ZONING
�
I• AT (LOCATION) (..-/ DISTRICT
LOCATION N ) (STREET)
OF
BETWEEN�Gt r AND
BUILDING c (CROSS STREET) CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
11. TYPE AND COST OF BUILDING A11 applicants complete Parts A — D ;0
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
m
1J42_New building Residential Nonresidential
2❑ Addition(if residential, enter number 12P� One family 18❑ Amusement, recreational
of new housing units added, if any, OZ�
in Part D, 13) 13 ❑ Two or more family — Enter 19 ❑ Church, other religious
number of units— — — — --),. 20❑ Industrial
3 ❑ Alteration (See 2 above)
14 ❑ Transient hotel, motel, 21 Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 [71 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 — SpeciJy 25❑ Public utility
7 ❑ Foundation only
26❑ School, library, other educational
B. OWNERSHIP 27❑ Stores, mercantile
81$�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,,,••,,,•....... �j 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..............
31jP&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 �ublic or private company 50. Total land area, sq. 4t. ........... C. GjC
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. 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 bathrooms
Partial.......
DEPT. OF BUILDING INSPECTIONS BU�L��NG Z0 ;7 73 , 66
212 Main Street PERMIT
Northampton, MA 01060 PERMIT
35 - 21C VALIDATION
June 25 332
DATE � 19 $6 PE,�tJ+11T ore C
APPLICANT William Lesko ADDRESS North in
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO New Building (i) STORY One Family Dwelling DWELLING One OF UNITS +1
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
$$ West FArms Road ZONING S
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: permit for the construction of a new single family dwelling/2 floors
AREA OR 2`L00 sq. ft. ESTIMATED COST � 75 000.00 FEEMIT 41 673.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER Same as Applicant
ame as pp ican s B""
ADDRESS BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY ■ PINK - AS SSORS COPY pjNT ItP