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25A-058 (4)WVill. ZONING PLAN EXAMINERS NOTES DISTRICT FRONT SIDE - . SIDE YARD IX. 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IDENTIFICATION — To be completed by all applicants < Name Moiling address — Number, strcct, citN' and State ZIP code Tel. No. .STEP EN �; cos ARC �t �r 6 Owner or �� Moo's �y� ,y� �ry� Lessee '9��L.4 N / —[o®J /4/0,0—/I'T I ! V ©Y060 3� Builder's 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 B Date Plans B Notes 9 Fee Started y Approved y BUILDING PLUMBING MECHANICAL ELECTRICAL OTHER VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Date Dae Permit or Approval Check Obtained Number By Permit or Approval Check Obttatned 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 Permit number Building Permit issued vj r ,v-,'(,T 197. Building Permit Fee $ Certificate of Occupancy S Appr by. d...� Drain Tile S ✓ / / 14a' Plan Review Fee _ TITLE Crity of Nort4auytou � � .�lassrtclptsetfs T Offire of the �naptrtor of Auilbiugs APPLICATION FOR ZONING PERMIT AND Page Plot S-6 BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. /M p ZONING I •AT (LOCATION) 114 DISTRICT LOCATION (N0.) (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 7�0 M A. TYPE OF IMPROVEMENT D. PROPOSED USE – For"Wrecking" most recent use m 1 ❑ New building Residential Nonresidential 2 ❑ Addition(If residential, enter number 12❑ One family 18 ❑ Amusement, recreational of new housing units added, if any, in Part D 13) 13 ❑x Two or more family – Enter 19 ❑ Church, other religious number of units– – – – --> !A 20❑ Industrial 3 ❑ Alteration (See 2 above) 14❑ Transient hotel, motel, 21 ❑ Parking garage 45C 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) 24❑ Office, bank, professional 6 F7 Moving (relocation) 16 ❑ Carport 17 ❑ Other – Specify 25 ❑ 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•••••,.......... 10 — school, secondary school, college, parochial school, parking garage for, department store, rental office building, office building at industrial plant. To be insealled 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 $ 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 O 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 4 1 0 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 ores, sq. ft. ........... 43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed ....................... r F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL O 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........ I hereby certify that the proposed work is authorized by the owner<oC record and I have been authorized by the owner= to make this application as his authorized agent. SIGNA'TORE bF' -AGENT ADDRESS (NUMBER) (STREET) (CITY) APPROVED BY TITLE DATE 19 is 1 . i . r DEPT: FILE COPY, CITY OF NORTHAMPTON ZO `' BUILDING a. NORTHANmN, MA. o1o6o PERMIT 25A .� 58 PERMIT DATE May 2. 978 NO. 143 APPLICANT Sheila, N. Moos ADDRESS 16 Marshall Street, N'ton. (NO.) (STREET) (CONTR'S LICENSE) NUMBER OF PERMIT TO Rai r ragg d _nnA ( `�_) STORY Reraidenna DWELLING UNITS 2 (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ZONING AT (LOCATION) 16 Marshall Street DISTRICT URB (NO.) (STREET) m BETWEEN AND (CROSS STREET) (CROSS STREET) w LOT a SUBDIVISION LOT BLOCK SIZE m O O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION M O Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION F (TYPE) 0: LL REMARKS: Add new s*+arah - AREA OR PERMIT VOLUME ESTIMATED COST $ 5W-0n FEE $ 1().m (CUBIC/SQUARE FEET) ^ OWNER stAilb 8e Shei18 M[fOQ BU ADDRESS 16 Marshall ftmet, Northawton,, Ma, B S/ (Affidavit on reverse side of application to be completed by authorized agent of owner)