17A-127 (10) ZONING •
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
ENE
0 INS
IX. SITE OR PLOT PLAN For Applicant
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and Stag ZIP code Tel. No.
ne
Owner or
11
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.
Signature 0 applicant Address Application date
NOT WRITE BELO THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date P y Plans B Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approva I Check Date Number B Permit or Approval b B I Check Date Number Obtained y pP Obtained Y
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 FOR DEPARTMENT USE ONLY
Permit number
Building •� 19 Use Group
Permit issued
Building Fire Grading
Permit Fee $ � ' Live Loading
Certificate of Occupancy $ Occupancy Load
Drain Tile $ Approved by:
"7
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�. MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
Page Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. 0
ZONING
I• AT (LOCATION) LE DISTRICT'
LOCATION INO.) (STREET)
/� j
OF BETWEEN , /i '-"" ANU �
S
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
T-.
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D ;a
M
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use M
-f
1 ❑ New building Residential Nonresidential
2 D Addition(If 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 Transient hotel, motel,
❑ 21 Parking garage
4 El Repair, replacement or dormitory - Enter number
5 El Wrecking (If multifamily residential, of units ------- - --� 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
� t (�
6 Moving (relocation) 25 Public utility
17 C�J Other - Specify rge
7 Foundation only -r- 26 n School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
- �£
8 �Privote (individual, corporation, )� t P 28 L] Tanks, towers
r% �' �`� j`.i 1£'
nonprofit institution, etc.) t 29 t r
-] 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,,,•,........... r £ 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 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
48. Number of stories..............
30 asonry (wall bearing) 40 Public or private company
Private (septic tank, etc.) 49. Total square feet Floor area,
41
31 Wood frame �� p all floors, based on exterior
32 L� Structural steel dimensions ..................... j
33 Reinforced concrete H. TYPE OF WATER SUPPLY
p
34 Other - Specify 42 L J Public or private company 50. Total land area, sq. ft. ........... 1 {
�
43 �_] Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 C]y"as Will there be central air 52. Outdoors......................
36 conditioning?it s L. RESIDENTIAL BUILDINGS ONLY
37 [7 Electricity 44 � Yes 45 No 53. Number of bedrooms..............
38 n Coal
39 Other - Spcci/y Will there be an e evator� Full..........
54. Number of
�Nc bathrooms
46 Yes I,` Partial... ....
47
DEPT. OF BUILDING INSPECTIONS BUILDING
212 Main Street 00
4 -
Northampton, MA 01060 PERMIT as
17A - 127
VALIDATION
DATE_ Jame 23 19 88 PERMIT No. 382
APPLICANT Rirharrl .T_ R, Judith M_ Wand ADDRESS 305 Bridge Road Flo. owner
(N0.) (STREET) (CONTR'S LICE'E)
PERMIT TO Alteration (_) STORY Garage NUMBERNG OF
UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) ��rl Bridge Ed_ Florence ZONING
DISTRICT URA
(NO.) (STREET)
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 3TRLCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION --------
family
(TYPE)
REMARKS: PpLui.t far flue r.nm ercion of garage into 8 family room.
AREA OR 20.oo
VOLUME ESTIMATED COST 5,000.0® FEF�
ICUSIC/SQUARE FEET) ^Q
OWNER Richard J. & Judith M. Wancz k
ADDRESS 30 Bri ge iZoa t' orence BYILOING
JRS COPY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - P P)NT P