29-152 (9) ZONING •
DISTRICT
USE
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SIDE YARD
SIDE YARD
REAR YARD
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants '!
Name Mailing address — Number, strut, city, and State ZIP cod Tel. No.
Owner or
Lessee
Builder's
2. 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
00 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
Permit or Approval Check Obtained Number By Permit or Approval Check Date Obto fined 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 FOR DEPARTMENT USE ONLY
Permit number
Building. Use Group
Permit issued • l 19�i
Building Fire Grading
Permit Fee $ �'G
Live Loading
Certificate of Occupancy $ Occupancy Load
Ap roved by: e
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�► a
A*o& MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page 4 Plot !`SZ APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, Ill, IV, and IX. O
9 ZONING CA
I• AT (LOCATION) • DISTRICT
LOCATION IN 0.) (STREET)
OF BETWEEN AND
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
M
1 De NeN building Residential Nonresidential
2EJ Ad Jition(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 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 ——————— — --� 22 ❑ Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 Hospital, institutional
Part D, 13) 16 ❑
6 ❑ Moving (relocation) Carport 24❑ Office, bank, professional
7 ❑ Foundation ving (relocation)
only 17 ❑ Other — Specify 25�� Public utility
26 ❑ School, library, other educational
B. OWNERSHIP 27❑ Stores, mercantile
8 Pr vote (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,•••••,,,,•,„•, ,gsmo ! 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, enter2roposed use.
in the above cost
a. Electrical....................... �/ 1
b. Plumbing ..................... l/� I� 12—
c. Heating, air conditioning.......... `
d. Other(elevator, etc.)............. %
11. TOTAL COST OF IMPROVEMENT $3d-b 0
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..............
31 ® 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 ❑ 0 her — Specify 42 ❑ Public or private company 50. Total land area, sq. fT. ..........
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 Wi there be central air 52. Outdoors........................
36 ❑ oil conditi 'ng? L. RESIDENTIAL BUILDINGS ONLY
37 C f Electricity 44 �� Yes No 53. Number of bedrooms..............
38 � C a
39 ` 0 her — Spe i%y Will there b an elevator? Full..........
54. Number of
46 Yes 47 No bathrooms
Partial......
Department of ' i.ng Inspections
212 Main Stree '
Northampton, N01060 BUILDING oa
2 29 - 152 PERMIT
VALIDATION
DATE February 9, 19 84 PERMIT NO. 52
APPLICANT Edward Korzanowski ADDRESS 158 Line Street N/A
(NO.) (STREET) (CONTR'S LICENSE)
New Buildin g Recreational NUMBER OF
PERMIT TO (_) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
579 Rayn Raod D STN CT URA
AT (LOCATION)
(N0.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE 150 FT. WIDE BY 12 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS; permit to build a auxilary building 150' x 12' open sides - roof
AREA OR 1800 sQ. ft. ESTIMATED COST $ 3,500 FEEMIT 10 00
VOLUME
(CUBIC/SQUARE FEET)
OWNER
Northampton Revolver
I
ADDRESS 579 Rayn Road BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY PINK/- ASSESSORS COPY