25A-190 (31) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT
SIZE YARD SIDE YARD
IX. SITE OR PLOT PLAN For Applicant Use
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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 Stag ZIP code Tel. No.
i. ZA ��S�� g (� 6
Owner or
Lessee r
Builder's
L.
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
D0 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
q Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date 1 Date
Permit or Approval Check Obta ned Number By Permit or Approval Check Obtai ed 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
Build i-ng Use Group
Permit issued �at" /, 19 L_
Building Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
T
CITY OF NORTHAMPTON
�* �$ MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
IV T M
Page ELS 81) Plot Q APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O
I. / /'eI2 / ZONING
AT (LOCATION) Z� ��� � D 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 m
m
1 ❑ New building Reside al Nonresidential
2 El Addition(If residential, enter number 12 One family 18 ❑� Amusement, recreational
of new bousing units added, if any,
I Part D, 13) 13 ❑ Two or more family — Enter 19 ❑ Church, other religious
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 ❑ Wrecking (1l 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 ❑ Moving (relocation)
7 ❑ 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................ 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.)............. g
11. TOTAL COST OF IMPROVEMENT I$
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 ❑ 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 ❑ Y e s 45 F No
— 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevator? Full..........
54. Number of
46 [7:� Yes 47 ❑ No bathrooms
Partial.......
Department of Building Inspections
212 *Main Street BUILDING S°
Northampton, Ma. 01060 PERMIT 1a —104 Am. 00
25BD s 61 VALIDATION
DATE FPhrtja= 16, 19 R2 PERMIT NO. 59
APPLICANT -leb k FL Zal. sky ADDRESS 1()1 01 d Fertyd.
(NO.) (STREET (CONTR'S LICENSE)
NUMBER OF
PERMIT TO STORY N W bathroom DWELLING UNITS 1
TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION)
101 old Ferry Road DISTRICT RA
U
(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: ronVPrt PX7Ct1ng C1nSPt to k hath Ang1roximately 6' X 5'
AREA OR ESTIMATED COST $_ FEEMIT 10_00
VOLUME
(CUBIC/SQUARE FEET)
OWNER jpl+*+ .0 F1 i�ahpth 9a1 Pakv BUILD G D T.I
ADDRESS 1f11 Mr7 Ferry RA Nnrthamntnn, Ma_ 01060 BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT PINK '- A SORS COPY
�, _ m..... _r,._..���....�,�.
r
y
,.Departbimt of ftilding, Inspections
212 maill st"et Z 0
BUILDING 3-
Northamp Ma. 0 1060 1
0
tIT 2 a.
PERMIT 4
2311W 61
VALIDATION
DATE 19 Al PERMIT NO.
APPLICANT -"- m rL zalasky ADDRESS 4, 01A 1!�x�
ld
(No (STREET)"
(CONTk'S LICENSE)
PERMIT TO Al NUMBER OF
(TYPE OF�Jaa--(J—) TORY Nair h&t DWELLING UNITS
IMPROVEMENT) NO. IS (PROPOSED USE)
AT (LOCATION) 101 Old ierry ad ZONING
—DISTRICT
(NO.) (4TREET)
BETWEEN AND
(CROSS STREET)
(CROSS STREET)
SUBDIVISION —LOT—BLOCK—SILOT ZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SMALL CONFORM IN CONSTRUCTI�O`N'
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: comart AXIAttas tolftaa� ta bAth Aftroximately 6" X
AROELA M r FE
( PERE MIT
VU ESTIMATED COST $ 2-000 $ if 10-oo
(CUBIC/SQUARE FEET)
OWNER john & 111VAlhath
BUILD 7/T-.
By ))X/G 4
ADDRESS ickl 91A psltz;t ga- 3tA,=*tQMp MAP 01060*
WK�TE FILE �OPY GREEN ^ FIELD- COPY CANARY APPLICANT C(011w PINK A I M'S-tORS COPY