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No, llich&el R. ;,nd 1300 Burt 's -'Pit Road 01060 584— Lessee Pa,mela K. Ptxsons Northiim-pton, 01060 5024 R. Skrocki License No. 527— Contractor (Vner (Porch) --Above 6622 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 DO NOT WRITE 8EL0 W TH | S L | NE V. PLAN REVIEW RECORD — For office use Plan Review Date Plans Date Plans Plans Review Required Check Fee Started By Approved By Notes BUILDING $ PLUMBING $ MECHANICAL $ OTHER 's VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Date Date Permit or Approva I Check Obta ined 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 V11. VALIDATION Building Permit number Permit issued 19 1 Building Aqcl by- Drain Tile Plan Review Fee TITLE ' •�p� Tp�. �" Cris of Nort4amvton � � �lxssxclfusetts �t T' Office of the �nsprrtor of 'Puilbings APPLICATION FOR Page 35 Plot 201 ZONING PERMIT AND BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. ] p I •AT (LOCATION) 1300 Burt Is Pit 2�Q 0 loll .d DISTRICT CT LOCATION (NO') (STREET) t{�{{. OF BETWEEN Ryum� Road AND ?Pv18 U�d00d. 1erryice tea' BUILDING (CROSS STREET) (CROSS STREET) ry j SUBDIVISION i` �'t A� )11c°.b1e LOT1BLOCK_f i S�ZE 1.011 ,�C. Cn II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D 7�0 M A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use M 1 [A New building Reside 'al Nonresidential 2 FZ 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 ❑ Church, other religious in Past D, 13) 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 F-1 Wrecking (If multifamily residential, of units ------- - --> 22 Service station, repair garage enter number of units in building in 15 ® Garage 23 ❑ Hospital, institutional �J Part D, 13) 24❑ Office, bank, professional 6 ❑ Moving (relocation) 16 ❑ Carport 17 ® Other - Specify 'Qrph 25❑ Public utility 7 ❑ Foundation only 26 ❑ School, library, other educational B. OWNERSHIP 27 ❑ Stores, mercantile 28 Tanks, 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 rr�� processing plant, machine shop, laundry building at hospital, elementary 10. Cost of improvement................ U0#UV school, secondary school, college, parochial school, parking garage for, deportment 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 200.00 a. Electrical..................... b. Plumbing ..................... TT lY t � c. Heating, air conditioning.......... N/A d. Other(elevator, etc.)............ YVA 11. TOTAL COST OF IMPROVEMENT $ 3700-00 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. D Q E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS 1 m 40 Public or private company 48• Number of stories............... 30 Masonry(wall bearing) ❑ 320 -' , 31 Wood frame 41 ® 49. Total square feet of floor area Private (septic tank, etc.) all floors, based on exterior 32❑ Structural steel dimensions ..................... t, .r' '• @ w 33❑ Reinforced concrete H. TYPE OF WATER SUPPLY 34❑ Other - Specify 42 EZ Public or private company 50. Total land area, sq. fT. ........... 46.650 43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed ....................... 2 Pr 0 . ]r - F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL O 35 ❑ Gas Will there be central air 52. Outdoors........................ 3+ 36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY p 37 F—] Electricity 44❑ ® I Yes 45 No 53. Number of bedrooms.............. T/A Q 38 ❑ Coal 39 Other - Specify Y,one Will there be on elevator? 54. Number of Full.......... NIA bathrooms N, A 46 ❑ Yes 47 i No Partial........ ' F IJt Dtt .� W1 . hereby certify that the proposed °work is authorized by the owti and I have been authorized by'the owner to make- this Wlig'q� authorized agent. SIGNATURE OF AGENT u ADDRESS (NUMBER) (STREET) (CITY) APPROVED BY TITLE DATE. : 19 zo DEPT. FILE COPY DEPT. OF gu y jIMSpEC1V4 BUILDING Q(L 212 Main So" PERMIT %nhampton,Mom 010W 35-201 VALIDATION DATE SAj:)teMhAr I ! 19 7_ PERMIT NO. 44c) APPLICANT Mi eha.al R. P .reclna ADDRESS 300 Burts Pi Rd-- R (N0.)� (STREET) - (CONTR'S LICENSE) PERMIT.TO Porch - Gara-e ( 1 STORY Detached Garage - porch NUMBER N OF NITS 1 (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) AT (LOCATION) 0 RjrtIS Pj 1'. Rnad ZONING UPR (STREET) DISTRICT rn BETWEEN _ Ryan. Road AND Westwood Terrace a - - (CROSS STREET) (CROSS STREET) m SUBDIVISION LOT BLOCK SIZE 9 .071 a U BUILDING IS TO BE 22 FT. WIDE BY 26 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION M O Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION f � (TYPE) O REMARKS. -DA-tat-hp(i garagp, 9nd nAd nornh to hoilep 171 X 201 AREA OR MIT VOLUME ESTIMATED COST $ 00.Oa FEE $ 12.00 (CUBIC/SQUARE FEET) OWNER Michael R & Pamela K Parsons LD T ADDRESS —1,3 Rllrt Is Pit Rd. , NI ton. (Affidavit on reverse side of application to be completed by authorized agent of owner)