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28-053 (9) ZONING • DISTRICT USE FRONT YARD SIDE YARD c-, SIDE YARD REAR YARD NOTES IX. 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IDENTIFICATION — To be completed by all applicants 0" Name Mailing address — Number, strcct, city, and �rntc ZIP code Tel. No. Owner or � �, ----- Lessee + wi lder'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 -icve 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 appli ant Address Application date /// DO NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Required Check Plan Review Date Plans By Date Plane By Notes Fee Started Approved BUILDING PLUMBING MECHANICAL ELECTRICALa OTHER VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS ate Do-e Permit or Approval Check ObDtained Number By Permit or Approval Check Obta ned 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 ZS Building _ Permit issued N � 19� Building Permit Fee $ .1O. 610 Certificate of Occupancy S Appro �• �; Drain Tile S Plan Review Fee S— ' TITLE C tx of Nort4ampton � � �'Ilxssxcllusctfs �6 Office of th' �e nsvtrtur of 'Puiffillps APPLICATION FOR ,> Plot ,`�r ZONING PERMIT AND Page BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, II, 111, IV, and IX. p ZONING K I• AT (LOCATION)_ ,2 /, �.�.'� _.f'i'} - -- DISTRICT LOCATION (NO.) (STREET) OF BETWEEN AND BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE N 11. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D 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 12XLOne 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❑ Transient hotel, motel, 21 ❑ parking garage 4 ❑ Repair, replacement or dormitory — Enter number 5 F-1 Wrecking (If multifamily residential, of units ——————— — -i 22 Service station, repair garage enter number of units in building in 15X Garage 23 ❑ Hospital, institutional Part D, 13) 24❑ Office, bank, professional 6 ❑ Moving (relocation) 16 [::] Carport 17❑ Other — Specify 25 ❑ Public utility 7 ❑ Foundation only 26 E] 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 r processing plant, machine shop, laundry building at hospital, elementary 10. Cost of improvement................ `g 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 t 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. y O E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS � m 48. Number of stories............... t .11 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 exterior f 32❑ Structural steel dimensions ..................... J (fC' f 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 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• tI tq Owner of record; and I have been authorized by the owner.•tQ. make ythis iapplication as phis authorized agent. : SIGNATURE OF 'AGENT ADDRESS (NUMBER) (STREET) { fiTY). APPROVED BY TITLE DATE 19 DEPT. BILE COPY Z0 ., CITY OF NORTMAMPTON BUILDING O NORTHAMPTON, MA. 01060 PERMIT VALIDATION 28-53 DATE OetobAr 31 , 19!22 PERMIT NO._a R APPLICANT_ W• J. Ix34ry Jr. ADDRESS 632 n SDI ton- (N0.) (STREET) (CONTR'S LICENSE) NUMBER OF PERMIT TO Construct GHre3�B (_) STORY C;arsa-1r'E3 DWELLING UNITS (TYPE OF IMPROVEMENT N0. ( OPOSED USE) Road ZONING 632 R AT (LOCATION) x� DISTRICT (NO.) (STREET) rn BETWEEN AND co (CROSS STREET) (CROSS STREET). m LOT IL SUBDIVISION LOT BLOCK SIZE m a O O BUILDING IS TO BE 15 FT. WIDE BY 40 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION m O USE GROUP BASEMENT WALLS OR FOUNDATION Z TO TYPE (TYPE) f 0' O LL REMARKS: AREA OR PERMIT VOLUME ESTIMATED COST $ 1��CC FEE $ 1oj0.(L- (CUBIC/SQUARE FEET) OWNER W. T T^nd r Tr BU ADDRESS 632 Ryan 52 .x,^—a ii , -Na rthaapU BY (Affidavit on reverse side of application to be completed by authorized agent of owner)