35-186 (6) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
1 d @
rf
# rr�...L
4 i 74+� P ( -g[ , dam-t g J
3 t .t {p -x z r a t �- t
�q�Y
g y g y
1,+-3 4-AL-111
g 3 a s
aom
5 t I # ,g 4 �, is-
- }{ t
H 11
z i-
a
r
144�
g 4 s t
t xL4yt f
1
s�,.
4:;_ _
11 t,
ia '- +`b
"w
a$-}a y�,1r z t I-
..
-
$¢ a $ g ^dT 4 w. r . a c ,v --�4i-' �i -I t t'
^ ' _€ t q 11: h 'P i
t t
14 i
-'H 4A ' t d +s r
# 4 L't 44
"4_ t-ir a t f 4 „+$?c'--gi°-+
a,
-�z a i++,rr
t - $ .d 4§- a . 7; z[14-
?€4 v S d T "" .
TIT 4 46 i ..y ; j r Ott{{ { 5 44
-1
r 5
"{dT
{' U41 ' ,i k
-
It N
4� r r r -.
1 prfiby
:"--
.-..
...
,
..
f�# �-5 i+4,T a
,a
'
r ; y zi .
f. ,.4
A
r ' a I EL ,. <. ..i +,a� tc, .. t.c.}..f "4 .e. .mod >r
BOCA FORM APEBP — 669 01969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
IV. IDENTIFICATION — To be completed by all applicants
Name p Mailing address — Number, street, city, and State ZIP code Tel. No.
1. ��l
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.
Signat a of applic t Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
lans 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
Permit or Approval I Check Date Number B Permit or Approval I Check Date Number B
pP Obtained y pp 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 '-'• CC Use Group
Permit issued 19
Building —L—
Fire Grading
Permit Fee $ L& Live Loading
Occupancy Load
Certificate of Occupancy
ved by:
Drain Tile
Plan Review Fee
TITLE
NOTES and Data — (For department use)
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 3 PLAN EXAMINATION AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. ('�.., o
13 p ZONING(`
I• AT (LOCATION) DISTRIC
LOCATION IN 0.) (STR T)
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 ❑ New building Residential Nonresidential
2 Addition(I residential, enter number
J 12 One family 18 ❑ Amusement, recreational
of new housing units added, if any, 13� Two or more family — Enter 19 ❑ Church, other religious
in Par[ D, 13) number of units— — — — -->
3 F-1 Alteration (See 2 above) 20 ❑ Industrial
14 ❑ Transient hotel, motel, 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (if 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)
❑
7 F—] Foundation only 17 Other — SpeciJy 25 ❑ Public utility
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•,,,,,,,,,,•,,,, V�C1 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 1$
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 Private (septic tank, etc.) 49. Total square feet floor area,
all floors, based on n exterior
32 Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other — Specify 42 [W 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 MECZA
35 ❑ Gas Wi here be cen52. Outdoors........................
36 Oil conditi ing?
L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 ❑ Yes 53. Number of bed rooms........
38 ❑ Coal
39 Other— SpeciJy Will there b an elevator. Full..........
54. Number of
46 Yes 47 o b athrooms
Partial.......
a
k
` w
NO
IVI
mm
NMI
gR
Sh
r
` +
t
u t _1
r
u
r
F
_
a
w
x.
3.
AIR
r y ,
I hereby certify that the proposed work is authorized by the owner of record
and I have been authorized by the owner to make this application as hW
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
r
DEPARTMT OF BUILDING INSPECTIONS DEPT. FILE COPY
ZO
212 TREET NORTON . 01060 BUILDING a
35 — 186 CODE #79 PERMIT VALIDATION
DATE November 16, ,9 79_ PERMIT NO. 670
APPLICANT Edwin Matusko ADDRESS 13W HYA n Rd.
(N0 ) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO In8t&11 WOnd RtOVe ( I STORY Whad.bi]T+n��pVA DWELLING UNITS
(TYPE OF IMPROVEMENT) Ryan (PROPOSED SE)
1397 Ryan Road ZONING SR
AT (LOCATION) DISTRICT
(N0.) (STREET)
w BETWEEN AND
10 (CROSS STREET) (CROSS STREET)
w
LOT
IL SUBDIVISION LOT BLOCK SIZE
M
t
U
O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
00
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
K
IL REMARKS: Install wood stave in e isx ti ng ehinmev_
Na 0.,e,. >
VOLUME ESTIMATED COST . 300,00 FEEMIT 10.00
(CUBIC/SQUARE FEET)
OWNER
Edwin at] ko f
BUILDIN DEP .
ADDRESS _._1397 Ryan Rd.. N'ton. _ BY _a�
(Affidavit on reverse side of application to be completed by authorized agent of owner)