17A-108 (3) Vill. ZONING PLAN EXAMINERS NOTES
SIDE YARD SIDE YARD
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, anti State ZIP code Tel. No.
Owner or
Lessee k"611 6 el �
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 his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature oll applicant Address Application date
15 tJ
00 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 $
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obttai 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
II. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number C
Bui(ding. , Use Group
Permit issued —r-f\C1,uA A 60 19�
Building Fire Grading
Permit Fee $ �
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved b
Drain Tile
Plan Review Fee
TITLE
CITY OF NORTHAMPTON
g+ �- MASSACHUSETTS
e OFFICE of the INSPECTOR of BUILDINGS
Page Plot o"t^/0 APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING UtZ
1• AT (LOCATION) �C�, / %f�-' DISTRICT'
LOCATION (NO.) (STREET)
r ! r �
OF BETWEEN I`. �'�/ i�t` / 5� -AND B 1 1 f'r}C `�"..C!�
BUILDING —� (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
11. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
X
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
M
1 New building Residential Nonresidential
2 ❑ Addition(It 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, 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)
6 ❑ ❑Moving (relocation) 16 Carport 24 ❑ Office, bank, professional
7 ❑ Foundation only 17 ❑ Other - Specify 25 ❑ Public utility
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8 X 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,,,,,,,,,,,,,,,, s 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 Is 61-000
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 X Wood frame 41 ❑ Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior �-
32 ❑ Structural steel dimensions ..................... C)
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........................
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 ❑ Yes 47���""ccc"'.� No bathrooms
- Partial.......
a DEPT. OF BUILDING INSPECTIONS BUILDING '°- 4 a n I. C(J'
! 212 Main Street Oa
Northampton, MA 01060 PERMIT <a
_,55 1",�-`Q� VALIDATION
DATE March 20, (g 86 PERMIT NO. 101
APPLICANT Sarajane & Leon Kostek ADDRESS 33 Claire Ave., Florence Owners
(NO.) (STREET) (CONTR'S LICENSE)OF
New Building etached 2 car ara a OWELLRING UNITS
PERMIT TO g (_) STORY �i
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
33 Claire Ave., Florence 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 bhe construction of a new detached 2 car garage
AREA OR 720 sq. ft. ESTIMATED COST $ 5,000.00 FEE
$ 36.00
VOLUME
(CUBIC/SQUARE FEET) ~
Same as Applicants �Ul
Same as !J
OWNER scan S
ADDRESS
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pjNT P