17C-032 (2) ZONING •
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
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NOTES and Data — (For department use)
�.
��o 4,:7 d
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, anti Stan ZIP code Tel. No.
-/
Owner or
Lessee
2• (
License icense 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 By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number B Permit or Approval Chec Dote Number B
Obtained y pP 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
II. VALIDATION
Building f'7( FOR DEPARTMENT USE ONLY
Permit number �J�7)
Building_ _
Use Group
Permit issued 19
1
Building Fire Grading
Permit Fee $ 10. Live Loading
Certificate of Occupancy $ Occupancy Load
prov by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
g. e MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
t Page �` Plot -3 APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, III, IV, and IX. O
ZONING
I• AT (LOCATION)
DISTRICT"`
LOCATION (NO.) /(STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vs
11. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use rn
rn
1 X New building Residential Nonresidential
2 ❑ Addition(If residential, enter number 121�0 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
number of units— — — — --o. 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 ——————— — -i 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)
17❑ Other — Speci/y 25 ❑ Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8 ❑J 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,,,,,,,,,,,,,,,, e.�) school, secondary school, college, parochial school, parking garage for,
j 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.).............
11. TOTAL COST OF IMPROVEMENT I$, a %
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 ) 48. Number of stories...............
y (wall bearing) 40 Public or private company
31 Wood frame 41 ❑ Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior
32 ❑ Structural steel dimensions ..................... y Y
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........................ —G-'
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? Full..........
�
� 54. Number of
46 F-] Yes 47 L_J No bathrooms
Partial.......
a DEP Of ,BUILDING INSPECTIONS BUILDING o° t i o '(Y�
! 212 Main Street 1
Northampton, MA 01060 PERMIT <a
17C - 32 VALIDATION
DATE *�
July 8, e 85 p MIT O. 386
APPLICANT Henry Kubosiak ADDRESS LYore reed
(NO.) (STREET) (CONTR'S LICENSE)
Demolition/New Bui np 2 Car Garage NUMBER of
PERMIT TO '1_ STORY g DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING URB
AT (LOCATION) 89 North Maple Street DIISTR CT
(N0.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE 20 FT. WIDE BY 24 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: P ermit for the demolition of a one car garage and to be replaced with a 2 car garage
AREA OR 480 sq. ft. ESTIMATED COST $ 2,200'00 FEEMIT 1000
VOLUME
(CUBIC/SQUARE FEET)
Same as Applicant
OWNER BUILD 4/�Z'
ADDRESS Same as A-pplicant S BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY ■ PINK - ASSESSORS COPY p0-1p