17A-103 (4) ZONING
DISTRICT
FRONT • .
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT
For .. .......
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — N:umber, stmt, city, and State nZIP
code
� Tel. No.
1.Owner or a (' (� J k'A" J ) ;i 'J/� ) A 9J" � '-<
P 1� C'Q"
Lessee
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 laws of this jurisdiction.
SligjlcVure of applicant Address ApWo plication date
J �! 3 i:i 12 �� e� �� l
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
9 Fee Started y Approved y
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 i/ FOR DEPARTMENT USE ONLY
Permit number
Building- Use Group
Permit issued 19
Building Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
ro'ed by:
Drain Tile
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
9` «$ MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page Plot 243 APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT — Applicant to complete al items in sections: 1, 11, III, IV, and IX.complete ll
I. Vim; ZONING
AT (LOCATION) 9'`— DISTRICTC.�`
LOCATION J/ (NO.) (STREET)'
OF BETWEEN , 4 I�l c. ,C�.. `.`. A N D ��r'.-G��Jt Lf�'�,�'✓`� `�
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vr
II. 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
--I
1 ❑ New building Residential Nonresidential
2 ❑ Addition([/ 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
number of units— — — — --> 20 ❑� Industrial
3 ❑ Alteration (.See 2 above) 14 l
t
l
t
t h
i
Transenoe , motel,❑ 21 ❑ Parking garage
4 ❑ Repair, replacement or 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 L❑ Hospital, institutional
Part D, 13) 16 ❑ Carport 24 ❑J Office, bank, professional
6 ❑ Moving (relocation)
17 Other — Specify❑1t L�Y . _ 25 ❑ Public utility
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP !z 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
ty 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 proposed use.
in the above cost
a. Electrical.......................
b. Plumbing .......................
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT I$
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 W.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
30❑ Masonry (wall bearing) 40 Public or private company Number of stories................ ' f
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 �{ �t
50. Total land area, sq. ft. ...........
34 ❑ Other — Specify 42 Public or private company
1!V
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........................ tf
36 �OiI conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 j Electricity 44 es
❑ Y 45 -- No 53. Number of bedrooms..............
38 Coal
39 ❑ Other — .Specify Will there be an elevator? Full....1
54. Number of
46 Lj Yes 47 :Jfl. bathrooms
Partial.......
hereby certify that the proposed work is authorized by the owner of record
and I have been authorized by the owner to make this applk0tion° 4s. his
authorized agent. r a
SIGNATURE OF AGENT _.
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
DEPT. FILE COPY
DTy;?ARTMENT OF BUILDING INSPECTIONS g U 1 L Q I NG O a _
212 1IN STREET �/�
NORTHAMPTONt MA. 01060 PERMIT VALIDATION
17A - 103
DATE September 11, 19 80 PERMIT NO. 484
APPLICANT_ 40SEPH SKOR112SKT ADDRESS 302 Brid&e Rd.
(NOJ (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO O STORY Attached deck DWELLING UNITS 1
TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) Bridge Rd. DISTRICT URA
(NO.) (STREET)
Ch BETWEEN AND
(CROSS STREET) (CROSS STREET)
a
a. LOT
M SUBDIVISION LOT BLOCK SIZE
Q Deck
U WJGK�MIS TO BE g. FT. WIDE BY 10 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
a
Z TO TYPE USE GROUP BAS NT WALLS OR FOUNDATION
g (TYPE)
0
LL REMARKS:
AREA OR 0\1W
VOLUME ESTIMATED COST $ 250_00 PERMIT
VOLUME $ 1
(CUBIC/SQUARE FEET)
OWNER _ ingpp l Skorupski
B LD
ADDRESS 312 Bridge R-. _ Nr �ton., Ma. 01060
(Affidavit on reverse side of application to be completed by authorized agent of owner)
IL
INSPECTION RECORD J
DATE NOTE PROGRESS - CRITICISMS AND REMARKS INSPECTOR
FIELD COPY
agPARTKMT OF IUrLDING INSPBCTIONS BUILDING
212 NAM STRM PERMIT
IIoni1Mri'ig MA. 41060
17A - 103
� DATE �I.@1�tCm ►cr 112. 190 PERMIT NO. 4'84
APPLICANT ADDRESS 302 Bridge Rd.
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF 1
PERMIT TO NAM d4k&k ( k) STORY Attac-h-IA deck DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
Ave ONING
AT (LOCATION) 302 B�riye Rd, DISTRICT
(NO.) (STREET)
rn BETWEEN AND
.o (CROSS STREET) (CROSS STREET) 1111
rn
^ LOT
(L SUBDIVISION LOT BLOCK SIZE
m
a I)!L'k
p IS TO BE 9 FT. WIDE BY 10 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
� (TYPE)
O: attacked y
u- REMARKS: C� tru t attacked deck
i
I
n PERMIT
VOLUME ESTIMATED COST 25V.00 FEE 10.0
(CUBIC/SQUARE FEET)
! OWNER Joseph Skorupski IL
ADDRESS 302 Bridge Rd.• N`ton. Ma. 01060