17A-206 (6) ZONING •
DISTRICT
FRONT YARD
SIDE YARD 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 Mailing address — Nurtrber, street, city, and State ZIP code Tel. No.
Owner or ,
Lessee M /
Bui Ider'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 a thorized agent and we agree to conform to all applicable laws of this jurisdiction.
Si natur of applicant Address Application date
00 NOT WRITE BELOW T AS LINE
V. PLAN REV RECORD or office use
Plans Review Required Check Plan Review Date Plans B Date Plans By Notes
Fee Started y Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER Is
Vi. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Permit or Approval Check Obtained Number By Permit or Approval Check Obtta fined 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 /y FOR DEPARTMENT USE ONLY
Permit number CC���l/
Building Use Group
Permit issued 19
Building
Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $ %�"�"► (�.u17ej
it
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�. .� MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
w T
Page Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, I1, 111, IV, and IX. O
J 1 ZONING
I• AT (LOCATION) �1 DISTRICT
LOCATION (NO.) � (S REET) �`��
OF BETWEEN �yt%LJ/ AND C/?J/
BUILDING (CROSS'STREET) ( OSS 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 Residential Nonresidential
2 Addition(1 residential, enter number
/ 12 ❑ One Family 18 ❑ Amusement, recreational
of new bousing units added, if any,
in Part D, 13) 13 Two or more family - Enter 19 ❑ Church, other religious
number of units- - - - --�� 20 L❑ Industrial
3 ljLteration (See 2 above) 14 l
l
t
h
i
Transent hotel, mote ,
❑ 21 Parking garage
4 ZRepair, replacement or dormitory - Enter number l
5 ❑ Wrecking (If multifamily residential, of units ------- - -i 22 LJ Service station, repair garage
enter number of units in building in 15 Garage 23 ❑ Hospital, institutional
Part D, 13)
16 ❑ Carport 24 F[-] 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 Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 ❑ Other - Specify
9 L❑ 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,,,,,,,,••,,,,,, 40Z +''-z:l 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.......................
b. Plumbing .....................
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $
III. SELECTED CHARACTERISTICS OF BUILDING — For new buil t gs and ad tions, 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 ....................
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 .......................
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 Electricit �' No
C� Y 44 F—] Y e s 45 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other - Specify Will there be an elevator? Full..........
-" 54. Number of
46 [_� Yes 47 J No bathrooms
Partial.......
DEPT. OF BUILDING INSPECTIONS BUILDING Z°
212 Main Street oa $10 , 66
Northampton, MA 01060 PERMIT
17A - 206 VALIDATION
DATE May 12, Ig 87 PERMIT NO. 270
APPLICANT Mitchell Jasinski ADDRESS 4 owe t. , Flo. wner
(NO.) (STREET) (CONTR•S LICENSE)
XAXX Replacement PERMIT TO p acement (`) STORY Deck NUMBER OF
DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) _ 137 North Maple Street ZONING URB
(N0.) (STREET) DISTR ICT
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: permit for the replacement of existing deck on front of existing 2 family dwelling
7' X 7'
VOLUME 49 sq. ft. ESTIMATED COST .$ 200_00 PER
(CUBIC/SQUARE FEET)
OWNER Same as Applicant li l
BUILDING
ADDRESS Same as Applicant's BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSES ORS COPY 01NIP
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