29-436 (4) ZONING •
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
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NOTES and Data — (For department use)
W- e•.,
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or 16161,q6- hl,
Lessee /{t
u to Z' y�,
is2. �I� p -i 5 C/7/C0 "P 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 date
40 NOT WRITE LOW THIS LINE be,
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date P y Plans B 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
Building Use Group
Permit issued Iry fq
Building \\ \/,�s� Fire Grading
Permit Fee $ �L1 � V Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
*a+Ap-j CITY OF NORTHAMPTON
g. MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
!V T
Page Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING ,.Ir
I• AT (LOCATION) DISTRICT
LOCATION (N0.) 5 REET)
OF BETWEEN are- 1C'f �.L.> ~. AND �I`f��/ t���(d'✓
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 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, 13 ❑ Two or more family — Enter 19 L❑ Church, other religious
in Part D, 13)
number of unzts— — — — 20 Industrial
3 ❑ Alteration (See 2 above)
14 Transient hotel, motel, 21 Parking garage��
4 ❑ Repair, replacement or dormitory — Enter number
5 El Wrecking ((I 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) _ 25❑ Public utility
17 Other Specz/
7 ❑ Foundation only �jj �(����''( 26❑ School, library, other educational
B. OWNERSHIP C fit' 7 27❑ Stores, mercantile
8 M 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
t 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 all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
48. Number of stories...............
30❑ Masonry (wall bearing) 40 [::] Public or private company /
31 ❑ Wood frame 41 El 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
50. Total land area, sq. ft. ...........
34 ❑✓ Other — Specify kll"I IIV. 42 Public or private company
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 C] Yes 45 rte, No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevators 54. Number of Full..........
46 ❑ Yes 47 ❑ No bathrooms
Partial.......
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a DEPT. OF�BUILDING INSPECTIONS I G Zo
212 Main Street BUILD N ]_
Da
Northampton, MA 01060 PERMIT
29 + 436 E VALIDATION
�r DATE May 12 �--�1�9y " ER�Q� NO. 1 ��
APPLICANT V ry � Matu`gexr�ADDRESS `41 6'l , on i} 1'�Ctr � 1��
(N0.) (STREET) (CONTR'S LICENSE)
Above Ground, Pool One �*aR4 NUMBER OF
PERMIT TO RRFF..�t (_l STORY J DWELLING UNITS
(TYPE Of IMPROVEMENT) NO. t/.� (PROPOSED USE)
t �S 43 EllL t o Roa ZONING um
AT (LOCATION) � DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
I
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: °,wi i14 for wian aristal i ati on of an above ground "pool eml 0sed with self l ock ate On
check,
PERMIT $ {
/� 1.--)00.00
VOLUME 241 dia, ESTIMATED COST � FEE
(CUBIC/SQUARE FEET) j
Joseph & MM Mat usewicz
OWNER
4S rtttl BUILD
! BY
E ADDRESS
WHITE - FILE COPY GREEN - FIELD COPY CANARY APPLICANT COPY • PINK - ASSESSORS COPY P'
I
a DEPT. BUILDING INSPECTIONS BUILDING ZO CO
212 Main Street 0 Y-+' `
Northampton, MA 01060 PERMIT
29 - 436 VALIDATION
DATE May 12 16
APPLICANT X Mary Matusewicz ADDRESS ing on Rd E;" �o"r 231 �
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO Above Ground Pool I-) STORY One Family NUMBER NG UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) __�_ % ___v_ 43 Ellington Road D�TR CT
(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 installation of an above ground pool enclosed with self lock gate on
deck.
AREA OR 24' dia. ESTIMATED COST $ 1,500.00 FEEMIT $ 10.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER Joseph & Mary Matusewicz
43 Ftttngron Road, BUILD?
ADDRESS BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pjNT 11P