12C-063 (5) ZONING •
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Ma'ling address — Number, str city, and State ZIP code Tel. No.
I. e . o/0 6CU CSG
Owner or V e� `' c �i
Lessee
i Builder's
2. �/M -1. k t �� License No.
Contractor q
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.
Sign ture of applicant Address Application date
&/-F
-16110-
NOT' WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number By Permit or Approval Check Date Number B
Obtained Obtained 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 Use Group
Permit issued 19
Building _ -0.13h. Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved •
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�. MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Paged Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ff ZONING
I• AT (LOCATION) h0 `/ �� �- DISTRICT
LOCATION (NO') (STREET)
r K
OF BETWEEN R1r-'17�`,� C:� Y AND At!'{,y .! `f «.•i'� t
BUILDING (CROSS STREET) (CROSS STREET)
> .- LOT "` y ,,,¢W
SUBDIVISION LOT BLOCK SIZE %'�
' .°`� ,t
Vr
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(/f 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
3 Alteration (See 2 above)
number of units— — — — 20 ❑� Industrial
❑ 14 Transient hotel, motel,
4 ❑ Re air, re lacement " 21 �_� Parking garage
p p or dormitory — Enter number
5 El Wrecking (If multifamily residential, of units ——————— — -i 22 L Service station, repair garage
enter number of units in building in 15 Garage 23 Hospital, institutional
Part D, 13)
16 ❑ Carport 24 L� Office, bank, professional
6 ❑ Moving (relocation)
17 ❑� Other — Sped/y 25 ❑� Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP 270 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„.............. Z% C-' 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..................... Clcl
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.
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 ..................... 1
33 L❑ 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 .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 ❑❑ Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 �J Electricity 44 ❑ Y e s 45 No
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 BWLDING INSPECTIONS BUILDING o< lL�
212 Main Street Ia
Northampton, MA 01060 PERMIT
12C - 63 VALIDATION
DATE April 22 ) 87 PER IT O. 204
APPLICANT Frank Kosier ADDRESS "ed' I ay�envi e
(NO.) (STREET) (CONTR'S LICENSE)
New Building etached Garage NUMBER of
PERMIT TO g l_) STORY Garage UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSEO USE)
11 Cloverdale Street ZONING URA
AT (LOCATION) DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE 24 FT. WIDE BY 30 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS, permit for the construciton of a 720 sg ft detached garage
AREA OR 720 $Q ft. ESTIMATED COST $ 14.000.00 FEE MIT $ 36.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER John Delaney C BUIL
ADDRESS 11 Cloverdale St. Florence BY 44
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY ■ PINK - ASSESSORS COPY p2-1-1 .P