23A-012 (7) DEPT. OF BUILDING INSPECTIONS212 Main Street
BUILDINGZo
/(.7 , ��
Northampton, MA 01060 PERMIT 3"
23A - 12 VALIDAT,ON
DATE March 11, 9 $7 E MIT No. 116
APPLICANT a� wy'iejht CQ Inc ADDRESS lid Industrtal' drLve On File
J INV./ STAMM (CONMro LICENSE)
Alteration/addition One NUMBER CF
PERMIT TO ti STd1Y Family DWELLING UNITS
STYIC M IMPROYEMCNTI NO. {MOPOSED USC/
28 Park St. , Florence ZONING URB
AT (LOCAT ION( DISTRICT .
0104 WNW)
BETWEEN AND
{CAMS snail cos( RilSiflETI
40T
SUBDIVISION LOT BLOCK SIZE
BUILDING 15 TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SMALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
ITM,EI
REMARKS( permit for addition of attic area ('I3 floor) for extra living space
AREA VOLUMER 192 sq. ft. ESTIMATED COST $ 1 ,000.00 FEEMIT $ 10.00
(CUBIC/SOUME YCCTI '`�y'�17,P ////�/1"/J '
AOWNER DDRESS Charlesa & Vicki Florend ' z" ,{/ /�
28 Park Street, Florence
BAH
a / Ct /{
WHITE - FILE COPY • GREEN • FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY NIH( F
lit a... — CITY OF NORTHAMPTON
MASSACHUSETTS
t 711!) OFFICE of the INSPECTOR of BUILDINGS
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• Page .3e Plot ick.
APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, II, III, IV, and IX. o
ZONING
1, 11 i5
AT (LOCATION) / > '/ 41 ��'� DISTRICT �.1
LOCATION (no.) ISTREETl
OF BETWEEN AND
BUILDING .CROSS STREET) ICRDSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
an
II. TYPE AND COST OF BUILDING - AU applicants complete Pans A — D —i
73
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
m
1 L_1 N5w building Resr_dlennj' Nonresidential we
2 RrAddition(If residential, enter number 121.ireirone family 18 I1 Amusement, recreational
of new ho usr ng units added, if any. 13 Two or more family - Enter 19 Church, other religious
in Part D, 13) ❑ gin s
3 H Ahmonon Der 2 above) n mber of units— - --i 2011 Industrial
14 ❑ Transient hotel, motel, 21 ❑ Parking garage
4I ' Repair, replacement or dormitory - Enter number
5 LI Wrecking (1/multifamily residential. of mats -y 2211 Service station, repair garage
enter number o/units In building in 15 ❑ Garage 23 [L Hospital, institutional
Pan U, 13) 24professional
6 ❑ Moving (relocation) 16 Carport Office, bank,
7 Li Foundation only 17 LiOther - Specify 25❑ Public utility
26 [Ti School, library, other educational
B. OWNERSHIP 271 J Stores, mercantile
28 E] Tanks, to'Me'
8 L.YPriva a (individual, corporation,
nonprofitinstitution, er ,) 291 I Other - Speai/y
9 I Public (Fedral, State, or
local government)
C. COST (Omit cents) Nonresidential - Describe in d.tail proposed Use of buildings, e.g., food
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement $ / p ( '.C- school, secondary echoo 1, 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 e.bnn building is being changed^enter proposed use.
in the above costal
a. Electric
b. Plumbing i A ^ Ae ^"A
W •
c. Heating, a r conditioning WEre-s-�r
d. Other (elevator, etc) \
11. TOTAL COST OF IMPROVEMENT $ f6 C Ci
III. SELECTED CHARACTERISTICS OF BUILDING - For new buildings and additions, complete Parts E - L;
for wrecking, complete only Part 1, for all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS .`
30[ll Masonry (wall bearing) 49 L-I Public or private c 48. Number of stories 5
ompanY 49 Total
31 h^'I Wood frame 41 ❑ Private (septic tank, etc.) floors,sbased feetonf efxterior ore
oilee»mono 7
32 �� S• tructural steel dimensions V Sr
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
341 I Other - Corinth' 42 ❑ Public or private company 50. Tonal land area, sq. ft
4311 Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL St Enclosed
3s L G• as Will there be central air 52. Outdoors
36 Ii aiii Oil . conditioning'
L. RESIDENTIAL BUILDINGS ONLY
37 Li E• lectricity 44 H Yes 45 1 No 51 Number of bedrooms
38 I Coal
39 Other- S(ecpy w ill there be on elevator' 54. Number of i{ Full
461 1 Yes 47111 No bathrooms
Partial
IV. IDENTIFICATION — To be completed by all applicants
1 Name // Mailing address - Number, street, ar and State ZIP code Tel. No.
C#Aetts /2r-41J _ f�R`k' i 7 c. $ -t
ow ., or
`/
Les... Ick 13ACi14 amvizS .tele-ICE?-=C 4_
z, t,�-lC1e11-7 IS 2sLace�eeri°.
/iS iNO�.;sr�LJrt A-2
(-)d-.'Ul /Into L'YL S AJC I%ZG'-N JiS 711' 5-8-6 8-A7
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 luri sdi ction.
Signature of applicant Address Application date
PKL3.ux, . LILL(tHki h'[Pies - s, A s s�e/ &7
00 NOT WRITE BELOW THIS LINE
'V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Dote Plans B y By
Date Plans Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Dote ate
Permit or Approval Check Obtained Number By Permit or Approva I Check Obtained Number By
BOILER PLUMBING _
CURB OR SIDEWALK CUT ROOFING
ELEVATOR SEWER
ELECTRICAL SIGN OR BILLBOARD
FURNACE STREET GRADES
GRADING r USE OF PUBLIC AREAS
OIL BURNER WRECKING
OTHER OTHER
VII. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number ! IVIJ
Per tryc^ uttr 1 ' 19 r� Use Group
Permit issued t `1 S- I
Building {�'\` Fire Grading
Permit Fee $ 10. 1 �� Live Loading
Certificate of Occupancy $ Occupancy Load
$ Approved b (/ C
Drain Tile � tj,t. /1 i//
Plan Review Fee $ �J�/
TITLE
NOTES and Data — (For department use)
VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
•
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
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