17C-074 (10) ZONING
FRONT DISTRICT
. .
SIDE •D SIDE 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 rjMailing address — .A...... ter^�hc'rt, rite, �nerl .Strnc° ZIP code Tel. No.
AO
Owner or
3 lrz tc c?iU GG
Lessee �(�
l• Builder's
L. 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 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
ate Date
Permit or Approval Check ObDtai ed 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
VII. VALIDATION
Building
Permit numberti�
Building
mit issued 19_
Permit Fee $ G�--------
Certificate of Occupancy S
Approved by:
Drain Tile
Plan Review Fee
o� ro
$ � i�assrtclptsetfs
of Nort4amptou
Offire of the �Inq ertor of �Buirbings APPLICATION FOR
ZONING PERMIT AND
Page Plot — BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, III, IV, and IX. O
r ZONING
I• AT (LOCATION) (9r}pEET)
LOCATION (NO.)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D m a
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use M
1 ❑ New building Reside tial Nonresidential
2 ❑ Addition(If residential, enter number 12 One family 18 E] Amusement, recreational l
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 VW
3 ❑ Alteration (See 2 above) 14 Transient hotel, motel,
❑ 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number IW
5 W Wrecking (IJ 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) 25 ❑ Public utility
17 ❑ Other — SpeciJy
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
28 Tanks, towers
8 Private (individual, corporation, ❑
�
nonprofit institution, etc.) 29 Other — SpeciJy
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 osed use.
in the above cost 1
a. Electrical.....................
r
b. Plumbing .....................
c. Heating, air conditioning.........
d. Other (elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT $ y c
III. SELECTED CHARACTERISTICS OF BiALDING — For new buildings and additions, complete Parts E — L; D
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 Rt
48. Number of stories...............
30 El Masonry (wall bearing) 40 ❑ Public or private company
Private (septic tank, etc. 49. Total square feet of floor area,
31 ❑ 41 Wood frame ❑ P ( p ) all floors, based on exterior
32 ❑ Structural steel dimensions ..................... V
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 F__] Other — SpeciJy
42 ❑ Public or private company 50. Total land ores, 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 bathrooms
No Partial........
I hereby certify that the proposed work is authorized by the owner. of record .
and I have been authorized by the owner to_make this application as his
authorized agent. _
SIGNATURE OF AGENT_
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
DEPT. FILE COPY
zD
TH
- CITY OF NORAMPTON BUILDING O a
NORTHAI'4"W, MAW• PERMIT
17C - 74 VALIDATION
DATE qen+PMhgr 1 _ 19- 22 PERMIT NO. 4o8
APPLICANT Raymond Fournier ADDRESS 33 Garfield Ave. • Flo.
(NO.) (STREET) (CONTR'S LICENSE)
1
PERMIT TO Demolition (,) STORY Demolition NUMBER OF DWELLING UNITS
. (TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING NRB
AT (LOCATION) Rear r' .rf i eld Avenue, Florence DISTRICT
(NO.) (STREET)
r BETWEEN AND
(CROSS STREET) (CROSS STREET)
T
LOT
L SUBDIVISION LOT BLOCK SIZE
D
D
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
I (TYPE)
it
0 REMARKS: T1SM.1 is a 0n Of one-faMily h=me i n=a-r of oune-C'S 'HOMe
AREA OR
VOLUME ESTIMATED COST $ 5360,00 FEEMIT $ 10.00
(CUBIC/SQUARE FEET)
OWNER Dymond & Carllyn Fournier
BUILDING D T.
ADDRESS 33 Garfield Avenue, Florence BY
(Affidavit on reverse side of application to be completed by author, a agent of owner)