25C-232 (5) ZONING •
DISTRICT
FRONT YARD
REAR YARD
IX. SITE OR PLOT
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address —SNumber, strret, city, and State ZIP c`�
ode Tel. No.
1.
Owner or olokv
Lessee
76-34 Builder's
2.
License No.
Contractor
3.
Architect or
Engineer
I hereby certif that the proposed work is authorized by the owner of record and that I have been authorized by the owner to
make his ap 0 cation as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signa a of app cant Address Applicati n date
,� Z•�' T fi'�'Pi' �f 1�
DO NOT WRITE BE OW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re wired Check Plan Review Date Plans By Plans B Notes
4 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Obtta tned Number By Permit or Approval Check Obtta t 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 �J
t,� 0 FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued ` ' `�, 19
Building J }, Fire Grading
Permit Fee $ " Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�• .� MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
t Page c- Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING
I• AT (LOCATION) ✓ ` �/ DISTRICT
LOCATION (NO.) (STREET)
OF /
BETWEEN i�' (CROSS STREET) AND �t. (CROSS STREET)
BUILDING
LOT
SUBDIVISION LOT BLOCK SIZE
Vf
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(1 residential, enter number
f 12 ❑ One family 18 ❑ Amusement, recreational
of new housing units added, if any,
in Past n, 13)
13 ® Two o more am Enter 19 Church, other religious r re fily — '� —
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 (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 ❑ Car art 24 L� Office, bank, professional
6 ❑ Moving (relocation) P
7 ❑ Foundation only 17 ❑ Other — Specify 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..................... e
b. Plumbing ..................... �ir ^_
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT Is 9
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildin s and additions, complete P is 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 C] 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 co 50. Total land area, sq. ft. ..
mpany """"
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 es ' o
�� Y 45 --- N 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevators Full..........
54. Number of
46 [_] Yes 47 '❑ No bathrooms Partial........
DEPT`. OF BUILDING INSPECTIONS BUILDING �O
212 Main Street 'Oa
Northampton, MA 01060 PERMIT
25C - 232 VALIDATION
DATE Mar. 21 , 19 89 PERMIT NO. 156
APPLICANT crA i g r,_ .1nhne ADDRESS 4� PomProv Terr. 049763
1N0.1 STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Alt�r�+ien��-Reaairs (-) STORY ThrPP Fa 1v DWELLING UNITS
(MYPE�F IMPNOVE ENT) N0. (PROPOSED U E)
qC ZONING URB
AT (LOCATION) 43Q Bridge Street. DISTRICT
(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: —pe -mi% fAr +hp a dermgr nn tI rd f! to inrrPacP thP hPiah
t of Stairway,
extend width of hallway to facilitate moving
AREA OR PER MIT
VOLUME ESTIMATED COST $ inn nn FEE $ 16-no
(CUBIC/SODARE FEET)
OWNER Bernie Golab
161A B UILDING 0
ADDRE Ort am p on a$$. BY -�
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