35-021 (9) vill. ZONING PLAN EXAMINERS NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
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NOTES and Data — (For deportment use)
s
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, anti .State ZIP code Tel. No.
Owner or
Lessee
2. t _ 4 P� \ e Q Licenser�No. /
Contractor \
AAA 0/0 60
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.
S g tire of applican Ad ress rr f--� I Application date
C
DO �/NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
9 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Obta tned Number By Permit or Approval Check Obta 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
II. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building
Use Group
Permit issued -" _I 19 �
Building ,. / ��I Fire Grading
Permit Fee $ r
Live Loading
Certificate of Occupancy $ Occupancy Load
rov d by:
Drain Tile $ `
J
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
9� +� MASSACHUSETTS
$ e OFFICE of--the INSPECTOR of BUILDINGS
Page Plot ~�-� APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT - Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
1 J �
I• AT (LOCATION) QQ,tJ Z� J c3. n -� DISTRICT
LOCATION (N0.) (STREET)
OF BETWEEN�V�1.7 VCCJP'A AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE—1 jr
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;K0 no family 18 ❑ 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- - - - -� 20❑ Industrial
3 Alteration (See 2 above) 14 l
t
l
t
t h
i
Transenoe , motel,❑ 21 ❑ Parking garage
4❑ Repair, replacement or dormitory - Enter number
5 ❑ Wrecking (If multifamily residential, of units ------- - --0. 22 ❑ Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional
Part D, 13)
6 ❑ Moving (relocation) 16 ❑ Carport 24❑ Office, bank, pro{essional
17 ❑ Other - Specify 25❑ Public utility /
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8 J�Zj 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................ r
31 �Wood frame 41 X Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based o exte[[ior
32 F-1 Structural steel dimensions ...✓ :.�"1:.........
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ 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 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 15< 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........
DEPT. OF BLNLDING INSPECTIONS BUILDING �° $493.00
! 212 Main Street Oa I IL
Northampton, MA 01060 PERMIT
35 - 21 - B VALIDATION
DATE May 19 Ig 85 PERMIT NO. 220
APPLICANT Edgar J. Lesko Jr. ADDRESS 75 Barrett Street
(NO.) (STREET) (CONTR'S LICENSE)
New Building XXERM One Family Home NUMBERNG UNITS 1
PERMIT TO (_) STORY
(TYPE OF IMPROVEMENT) NO. (PROPOSEO USE)
Lot -B West Farms Road ZONING SR
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: t%MO�M permit for the construction of anew single family dwelling with
one rloor
AREA OR 1232 sq. ft. ESTIMATED COST $ 50,000.00 FEE $ 493.00
VOLUME
(CUBIC/SQUARE FEET) +
OWNER Same as Applicant BUILD
ADDRESS Same as Applicant BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pw P
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