17A-294 (2) Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
IX. SITE OR PLOT PLAN For Applicant Use
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NOTES and Data — (For department use)
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IV. IDENTIFICATION — To be completed by all applicants j
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
V I / d/
I
Owner or /
Lessee olo��
/ s,7,`3
f
Builder'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 have been authorized by the owner to
make this application as his authorized agent and we agree to conform to all applicable taws of this jurisdiction.
Si ture of app`licapt Address Application date
f
"fir•
DO NOT WRITE 4ELOW 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 $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
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
V11. VALIDATION ee��77
Building J / FOR DEPARTMENT USE ONLY
Permit number yY
Building.
Use Group
Permit issued 30 19
Building 0 Q�S
Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
Ap ed by:
Drain Tile $
Plan Review Fee $
TITLE
o CITY OF NORTHAMPTON
MASSACHUSETTS
r
$ e OFFICE of the INSPECTOR of BUI DINGS
Page-17 Plot c4l APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT — Applicant to complete all//it//ejjms in sections: 1, 11, 111, IV, and IX. O
I• AT (LOCATION) , • f�C../C.�`)/ „ /{/ ZONING
DISTRIC
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
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 Reside ial Nonresidential
2 Addition(If residential, enter number 12 rOne 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) l
t
l
t
t h
i
ransenoe , motel, 21 Parking garage
❑ ❑
4❑ Repair, replacement 14 Tor 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 ❑ Moving (relocation) 25 Public utility
7 ❑ Foundation only 17 ❑ Other — SpeciJy ❑ Y
26 School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 Private (individual, corporation,
28 ❑ Tanks, towers
nonprofit institution, etc.) 29❑ Other — Specify
9 D 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•••••••,•••••,•• S school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office building at industrial plant.
7'o 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 I$F2 (o4—?
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 �ood frame 41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior _
32 ❑ Structural steel dimensions ..................... Q G
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. PRINC,.IPAL 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 n Yes 45 I� No 53. Number of bedrooms..............
38 ❑ Coal
39 Other — .Sp�ci/y Will there be an elevator? Full..........
54. Number of
46 ❑ Yes 47 iej'No bathrooms Partial..e....
f
�o� oti C�LZt�r of eWart4aurptan
� �IdffdC�ltftttf -
r a z =
$ f Offirt of tltt )nzptrtor of JAuilbingf W
212 Main Street•Municipal Building
Northampton, Mass. 01060 .t
#213
CERTIFICATE OF OCCUPANCY
1tig-ust 12, 1985
Page No. 17A Plot 294
Building (Name) :ilr;LE tTtj"LY ')T.Z.II"4' r-rAkIfisi) GAPJGL' Address 110 �lil?crest Drive
Owner Diary KsieniaAcz Address W friri,t It Strpxnt
Applicant Salle Address `aas�►F-
Use: 1st 'Residentiral Occupancy
2nd Occupancy
3rd Occupancy
4th Occupancy
Zone District URA
1
Required Inspections:
New Building X Existing Building
Elevator Electrical
Plumbing Fire
GIB
Building Other ;
Inspector of Buildin
Department of Building Inspections
212 Main Street
Northampton, %ass. , 01060 BUILDING Z°
'- $837.57
PERMIT
17A - 294
VALIDATION
DATE June 1, 19 84 PERMIT NO. 218
APPLICANT Mary Ksieniewicz ADDRESS 10 Bright Street Home Owner
(N0.) (STREET) (CONTR'S LICENSE)
PERMIT TO
New Building (_) STORY One Family Home NUMBER OF 1
DWELLING UNITS _
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION)
110 Hillcrest Drive D STR CT URA
(NO.) (STREET)
BETWEEN AND
fCROS3 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: permit for the construction of a new single family home with garage attached.
—
Kitchen dining area, Living Room, one bath
((�� ' bath, 3 bedrooms.
2� REUME 2028 sq. ft. ESTIMATED COST $ 83,657.00 FEEMIT $ 837.'"57
(CUBIC/SQUARE FEET)
OWNER Mary Ksieniewicz
ADDRESS 10 Bright Street, Northampton, Mass. 01060 BY
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY • PINK - ASSESSORS COPY