23A-017 (15) VIII. ZONING PLAN EXAMINERS NOTES 417 -
DISTRICT v `
USE a
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
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NOTES ;
IX. SITE OR PLOT PLAN — For Applicant Use
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BOCA FORM APEBP — 669 C1969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
IV. IDENTIFICATION — To be completed by all applicants
Name /Mailing address — Number, street, city, and State ZIP code Tel. No.
1' �/t�'F N ti-� !"' / �yt; 2f�'T _ �:�Q?ll�y�� f•� C/G
Owner or
Lessee
{ / Builder's
2• f r3 Ct 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 au horited agent and we agree to conform to all applicable laws of this jurisdiction.
Signs e ofnapp�l'cant 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 Date
Permit or Approval Check Obtained 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 FOR DEPARTMENT USE ONLY
Permit number
Building a Use Group
Permit issued °_ >. 19
Building Fire Grading
Permit Fee $ 'a Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $ `
ITLE
NOTES and Data — (For department use)
. y
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 PLAN EXAMINATION AND
- -- 17 BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
/ ZONING
1• AT (LOCATION) DISTRICT
LOCATION (NOO (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vr
11. 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 Resi ential Nonresidential
2 F-1 Addition(If 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 ❑ Church, other religious
number of units- - - - � 20 ❑ Industrial
3 Alteration (See 2 above) 14 l
l
h
Transient hotel, mote ,
❑ 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory - Enter number
5 ❑ Wrecking (If multifamily 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 F-1 Moving (relocation)
7 ❑ Foundation only 17 Other - Specify T 25 ❑ Public utility
26 ❑ School, library, other educational
B. OWNERSHIP 7 ❑ Stores, mercantile
8A Private Private (individual, corporation, 28 Tanks, towers eci Other - S
nonprofit institution, etc.) — 29 ❑ 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,,,,,•••,••••••• �D 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$ DOS
III. SELECTED CHARACTERISTICS OF UILDING — 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 Number of stories........
31,4 Wood frame 411 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. ...........
43 Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed .......................
3 ❑ Gas Will there be central air 52. Outdoors........................
36/�Oil conditioning?
T L. RESIDENTIAL BUILDINGS ONLY
37❑ Electricity 44 ❑ Yes 45;k No 53. Number of bedrooms..............
38 ❑ Coal
39❑ Other- Specify Will there be an elevator? Full..........
54. Number of
46 ❑ Yes 47A No bathrooms
Partial.......
I hereby certify that the proposed work is authorized by the ownet- of record
and I have been authorized by the owner to make this application as his
authorized agent.
SIGNATURE OF.AG80t
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 14
REPARMW OF BUILDING INSPECTIONS Zo
DEPT. FILE COPY
212 FIRM STRM BUILDING 0aC
NORnWeToli, INIA. 01060
PERMIT
v VALIDATION
23A — 17 Code #79
DATE October 3, 19 79 PERMIT NO. 496
APPLICANT Sal Tagliareni ADDRESS 10 Park St., F�orenee
(NO.) {STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Chimney 8c BtOVe (_2_) STORY For wood-burning StoVE DWELLING UNITS I
(TYPE OF IMPROVEMENT) N0. (PROPOSED USE)
ZONING
AT (LOCATION) 10 Park DISTRICT IM
(NO.) (STREET)
rn BETWEEN AND
(CROSS STREET) (CROSS STREET)
a
IL LOT
m SUBDIVISION LOT BLOCK SIZE
a
0 BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
III
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
E (TYPE)
O:
O
U- REMARKS: Oran St Y97nt. masnnna3Z4 r_hl mY1ey r?` i msital lwnnc1..}17irnj rig ,gtn3Z _
AREA OR $
VOLUME ESTIMATED COST $ Q FEEMIT 1 nd
(CUBIC/SQUARE FEET)
OWNER Sal & Elaine Tagliareni
ADDRESS 10 Park Street, Florence, Ma. 01060 e DI T
(Affidavit on reverse side of application to be completed by authorized agent of owner)