35-126 (4) ZONING •
DISTRICT
L USE
FRONT YARD
SIDE - . SIDE YARD
REAR .D
IX. SITE OR PLOT PLAN For Applicant Use
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NOTES and Data — (For department use)
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IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — .timber, strccf, crtN, (1719 SIalc ZIP code Tel. No.
Owner or o� .)� .,G�,%✓ ,��?�` T�R�" QJ'L-
Lessee
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 date
4�)
00 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 Obtai ed Number By Permit or Approval Check Date Number By
Obta ned
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 t'
Permit issued 19 < /
Building
Permit Fee r(j '
Certificate of Occupancy
Appro by:
Drain Tile f
Plan Review Fee
i
TIT Lk
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i
Crx#y of 'Wart4amptan
� � �lassaclfusctfs
T Offire of the jWnspertor of {Aui(Dings APPLICATION FOR
Pages Plot /�-� ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, III, IV, and IX. Z
O
ZONING
• AT (LOCATION) �L 1' L•"✓ 'r `��� 1 l lC DISTRICT
LOCATION (N0.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
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
—i
1 ❑ New building Residential Nonresidential
2 X Addition(If residential, enter number 12 WOne fomily 18 ❑ Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 ❑ Two or more fomily — Enter 19 ❑ Church, other religious
number of units— — — — -.* 20 ❑ Industrial
3 ❑ Alteration (See 2 above)
14 Transient hotel, motel,
21 Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (11 multifamily residential, of units ——————— — •� 22 Service station, repair garage
enter number of units in building in 15.X Garage 23 ❑ Hospital, institutional
Part D, 13)
16 ❑ carport 24❑ Office, bank, professional
6 ❑ Moving (relocation)
17 ❑ Other — SpeciJy 250 Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP 27❑ Stores, mercantile
8 � 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,,,.•..•........ '• school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office building at industrial plant.
To be ins/ailed but not included If use of existing building is being changed,enter proposed use.
in the above cost
a. Electrical.....................
b. Plumbing ..........I............
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; ,o
for wrecking, complete only Part J, for all others skip to IV. D
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
m
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 ❑ Other — Specify 42 ❑ Public or private company 50. Total land area, sq. ft. ...........
430 Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed ....................... 0
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❑ Yes 45 ❑ No 53. Number of bedrooms..............
38 ❑ Coal
39❑ Other — Specify Will there be an elevator? 54. Number of Full..........
46 ❑' Yes 47❑ No bathrooms Partial........
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! hereby certify that the proposed work is authorize4,;by the vn :Aaf rsc�# ;
and ( have been authorized by the owner to make this application 'os �is
authorized agent.
SIGNATURE Or AGENT
ADDRESS
(NUMBER) (STREET) a jq[Tyk 4
M .,:'f i,
APPROVED BY TITLE
DATE 19
f
zn
DEPT. RLE COPY
City of Northaapton BUILDING O a
Northaapton, Mass. oto6o PERMIT
VALIDATION
35 - 126
DATE Septe112er 13, 19 77 PERMIT NO. 457
APPLICANT Albert W ('.a.rle ADDRESS 45 .ahi i l&n9
(Nd-.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO d r-kr& RO (�) STORY �.9rA1�'A DWELLING UNITS
(TYPE Of iM OVEMENTI N0. PROPOSED USE)
ZONING
AT(LOCATION) 45 Mhillem Te=aae DISTRICT_G+
ySR
(N0.) (STREET)
a BETWEEN AND
(CROSS STREET) (CROSS STREET)
a
a LOT
m SUBDIVISION LOT BLOCK SIZE
0 BUILDING IS TO BE 18 FT. WIDE BY 28 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
ID
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
0:
OL REMARKS: Con-stolet at"tacbed-garage
AREA OR PERMIT
VOLUME ,ESTIMATED COST FEE
(CUBIC/SQUARE FEET)
OWNER Albert Di Gyx10
B L
ADDRESS —T-Cabi].lone TeY` ae
(Affidavit on reverse side of application to be completed by authorized agent of owner)