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SIDE YARD SIDE YARD
IX. SITE OR PLOT PLAN For Applicant Use
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NOTES and Data — (For department use)
R!C AR 1
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — 'umber, street, city, and State ZIP code Tel. No.Ci
Owner or -�/ �
Lessee '���C=� C,'' F� 'r \ f t ,
Builder's
2
C Q 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.
Si2n p,ture
Ayoff!applicant /(/�� Address�/1 ///+ i Application date
icnt te
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans
Fee Started y Approved By Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL Is
OTHER Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number By Permit or Approval Check Date Number B
Obtained Obtained 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 �� FOR DEPARTMENT USE ONLY
Permit number _
Building Use Group
Permit issued _ 19
Fire Grading
Permit Fee t
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $ �
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
!Y T
Page /7 /9� 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
1• AT (LOCATION) l C /a ` P-,' V l DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN _ ® '4?—4-7 AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
H
11. TYPE AND COST OF BUILDING — All applicants complete Parts A — D ;a
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
m
-a
1 New building Resident Nonresidential
2 ❑ 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 ❑ Repair, replacement or dormitory - Enter number
22 L� Service station, report garage
5 ❑ Wrecking (11 multifamily residential, of its ------- - -� * r:
enter number of units in building in 15 Garage 23 Hospital, institutionoJ
Part D, 13) 24 ❑ Office, bank, professional
16 ❑ Carport ±
6 Moving (relocation)
❑ 17 ❑ Other - Specify 25 Public utility
7 ❑ Foundation only Q' 26 ❑ School, library, other educational
� t ti
B. OWNERSHIP 27 ❑ Stores, mercantile
8
28 Tanks, towers
Private (individual, corporation, ❑
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
��-)k. processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement••••,,,,•••••••, t/ 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
1
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 Lj Electricity 44 Yes 45 No
53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — .Specify Will there be an elevators Full..........
- 54. Number of
46 Yes 4 7 '❑ No bathrooms Partial........
DEPT. Of BUIEDING INSPECTIONS BUILDING Z9
212 Main Street Oa
Northampton, MA 01060 PERMIT
17 A-119
VALIDATION
Robert Graham DATE April 25 19 8_ PERMIT NO. 21.1
APPLICANT ADDRESS 20 Taft Aup FaCt,amptt,on on f 1f 1-�-. e
(NO.) (STREET) (CONTR•S LICENSE)
PERMIT TO New Bull nO (_) STORY NP fami 1 v riatarhp�i naranFOWELLING UNITS
(TYPE OF IMPRO EMENT) NO. ( POSED USE)
ZONING
F riniro AVE I'R.A
AT (LOCATION) 4 DISTRICT �-
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Setbacks are
)6XX j)4XX!XTO BE_ 4 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 to build a garage. (detached) 12' x 20'
AREA OR 240 $ f t. $ 5�000.00 FEEMIT $ 20.00
VOLUME q� ESTIMATED COST
(CUBIC/SQUARE FEET)
OWNER Hans Gregorski 'A'_
D
BUILyIryu'
acre ve. BY Vyr�
ADDRESS --
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY ■ PINK - ASSESSO S COPY p4jNT P