32C-236 (2) ZONING •
DISTRICT
USE
FRONT YARD
SIDE YARD S E YARD
REAR YARD
NOTES
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address - Aumbcr, strut, cith, aml �Ialc ZIP code Tel. No.
0 133 K& �
Owner or 3 CCl L-l�/���iS 0 10 6 0 �
Lessee f j(3 V,-r7t-4 A-1 n-7-2-) AJ A,1 4
Builder's
L. 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 applicant Address Application darner
;2 , y
D0 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
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
Permit number
Building w ��
Permit issued 19
Building
Permit Fee
Certificate of Occupancy S
Approved by:
Drain Tile S
Plan Review Fee /-
/� C C� Lrt ,
TITLE
O
ARSIN TC4118ft1s
�Y T t®f#ice of the �Inspertor of 'Puilbings APPLICATION FOR
ZONING PERMIT AND
Page .Plot 1-34, BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O
Y ZONING
I• AT (LOCATION) DISTRICT(4C(STREET)
LOCATION J (NO.)
OF BETWEEN /" AND A
BUILDING (CROSS STREET) (CROSS STREET)
SUBDIVISION LOT BLOCK SIZE )^
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D m
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use M
1 ❑ New building Residential Nonresidential
2 ❑ Addition(If residential, enter number 12 One 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 Transient hotel, motel,
❑ 21 ❑ Parking garage
40 Repair, replacement or dormitory — Enter number
5 F-1 Wrecking (If multifamily 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) p
g ) 17 ❑ Other — Specify 25 ❑ Public utility
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
28 ❑ Tanks, towers
8 Private (individual, corporation,
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................ `✓ 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 a/I others skip to IV. y
O
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS I I— M
48. Number of stories...............
30❑Masonry (wall bearing) 40 �Public or private company
41 ❑ Private (septic tank, etc.) 49• Total square feet of floor area,
31 Wood frame all floors, based on exterior
2 1v
32❑ Structural steel dimensions .................... Al s
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
50. Total land area, sq. ft. ........... s/.3C� n
34❑ Other — Specify 42 Public or private company �i
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES o
51. Enclosed ....................... O
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 0
35 Gas Will there be central air 52. Outdoors........................ C)
conditioning?
36 ❑ Oil L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44❑ Yes 45 ® No 53. Number of bedrooms..............
38 ❑ Coal j
39 ❑ Other — Specify Will there be an elevator? Full..........
54. Number of
❑ Yes 47 bathrooms
46 �o Partial........
I hereby certify that the proposed work is authorized by the owner of record
and i have been authorized by the owner to make-.this application 'as his
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
.. �, Z O
DEPT: FILE COPY
CITY OF NORTHAMMIN BUILDING <a
NORM M MN, MASSE 32C - 236 PERMIT VALIDATION
DATE November 21, 192 PERMIT NO. 761
APPLICANT dwa.7-d C. Barker ADDRESS I Williams
(ND.) (STREET) (CONTR'S LICENSE)
p �+11 NUMBER OF
PERMIT TO ReridenCe - Remofi9l ( ) STORY Bathroom DWELLING UNITS 1
(TYPE OF IMPROVEMENT) N (PROPOSED USE)
ZONING
AT (LOCATION) 15 Williams DISTRICT URC
(NO.) (STREET)
as BETWEEN Hancock AND Easte=
(CROSS STREET) (CROSS STREET)
LOT
a
IL SUBDIVISION LOT BLOCK SIZE 45 X 114
a
U
O BUILDING IS TO BE FT, WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM. IN CONSTRUCTION
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
LL REMARKS: Remodel Ba :thr m
AREA OR PERMIT
VOLUME ESTIMATED COST $ 87§�A(t FEE $ 10 oo
(CUBIC/SQUARE FEET) /4l)
OWNER Eduamd C- &Acker BU DIN b T.
5,,�
ADDRESS 1 Williams Strest,. Northampton BY
(Affidavit on reverse side of application to be completed b orized agent of owner)