35-162 (5) ZONING •
DISTRICT
FRONT YARD
YARD
SIDE YARD
REAR l
. I —
NOTES
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
1.
hr, 2l ' 9'3 ti z h"1 o�o�0 19a8
owner or
Lessee
Bui Ider'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 FLOW 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 Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
ate Date
Permit or Approval Check ObDta ned 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 -1 FOR DEPARTMENT USE ONLY
Permit number 3'—, �
Building n Use Group
Permit issued C: 1 19 _
Building _ Fire Grading
Permit Fee $ L ` k') Live Loading
Certificate of Occupancy $ Occupancy Load
$ Approved by:
Drain Tile
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�• _ MASSACHUSETTS
• a
e OFFICE of the INSPECTOR of BUILDINGS
Page Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, II, 111, IV, and IX. 0
C) '�''") �//q
ZONING
• AT (LOCATION) 5I tom,3 �V C) r 1�. O rte(' (� / DISTRICT
LOCATION (NO.) (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 rn
rn
1 [:] New building Residential Nonresidential
2 Addition(/ 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 n Church, other religious
number of units- - - - -� 20 Industrial
3 Alteration (See 2 above)
14 Transient hotel, motel,
4 Repair, replacement 21 C� Parking garage
p p or dormitory - Enter number
5 ❑ Wrecking (11 multi family residential, of units ------- - 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)
17 Other - Speci/y 25 n Public utility
7 Foundation only
26 School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
856 Private (individual, corporation, 28 n Tanks, towers
nonprofit institution, etc.) 29 Other - Specify
9 F] 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,,••,,•••....... 0 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..................... ''n �' D 1
�11P C�1"O✓hC� .JuU I �m�� d 00 Ij
b. Plumbing ..................... � I L�1 ilk✓,
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
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 C� Public or private company 50. Total land area, sq. ft. ..........
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ......................
35 Gas Will there be central air 52. Outdoors........................
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 [-] Yes 45 -I No 53. Number of bedrooms..............
38 Coal
39 Other - Specify Will there be an elevator? Full..........
54. Number of
46 [_� Yes 47 D No bathrooms
Partial.......
a DEPT. OF BUILDING INSPECTIONS BUILDING
! 212 Main Street oa
Northampton, MA 01060 PERMIT <
35 - 162 E� j jVQ VALIDATION
DATE Mrl�( �__79A9MT89' Pf'lUr��fll.e 283 NMI
APPLICANT Michael Samolewicz ADDRESS j ►r�(
(N0.) (STREET) (C QNTR'S LICENSE)
PERMIT TO Above-Ground Pool(_) STORY One Family DWELLING OF
UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING �)K
AT (LOCATION)
793 Ryan Rd. DIISTR 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: ermit for an above ground pool 241 diameter. An electrical permit is required
VOLUME 24 1 d i diameter ESTIMATED COST 2,000-00 oo FEEMIT 10.00
(CUBIC/SQUARE FEET)
OWNER Applicant BUILDIN ugt_4
ADDRESS �r�ITIP a,, AQn 1 i can I S - BY eat�z��fz
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