17A-221 (6) ZONING •
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NOTES
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IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
n
�1
Owner or �il�tt - l�vt P1 1/U
Lessee 1 •\ r L AA A L\ .
V i.(•kJ��Z:•- •s i i
I / %l` Builder's
2. �. tr!'- <jt��:y !, 'A� 't License No.
4
Contractor r
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.
Si re of appl c nt Address Application date
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 Is
OTHER $
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Dae Date
Permit or Approval Check Obtta±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 of
Building Use Group
Permit issued 19
Building Fire Grading
Permit Fee $ v ' Live Loading
Certificate of Occupancy $ Occupancy Load
Approved b
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
$ e OFFICE of the INSPECTOR of BUILDINGS
Page Plot—2 APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. 0
ZONING
I• AT (LOCATION) .� t �r �'t 7T DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN 4. AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT r
SUBDIVISION LOT BLOCK SIZE = '/-Z�'+_'"'p
N
II. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
M
1 ❑ ew building Reside tial Nonresidential
2 yAddition(IJ 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 (I/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) ❑
16 Carport 24❑ Office, bank, professional
6 ❑ Moving (relocation)
7 ❑ Foundation only 17 ❑ Other - Specify 25 D Public utility
26 ❑ School, library, other educational
B. OWSHIP 27❑ Stores, mercantile
8 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,,••,•;,,,,•..,, 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 1$ OC c
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❑ asonry (wall bearing) 40 K6ublic 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 as Will there be central air 52. Outdoors................
36 u vil conditioning?
L. RESIDENTIAL BUILDINGS ONLY ,
37 ❑ Electricity 44 ❑ ,
Yes 45 'f No 53. Number of bedrooms..............
38 ❑ Coal +�
39 ❑ Other - Specify Will there be on elevators Full.......... L
54. Number of
46 [-1 Yes 47 o bathrooms Partial........
DEP-f. OF BUILDING INSPECTIONS BUILDING 'z � � 7
+ ! 212 Main Street oa
Northampton, MA 01060 PERMIT
17A - 221 rn VAkA , ` VALIDATION
DATE 19 86 PERMIT NO. 201
APPLICANT Mark Power.-, ADDRESS 31 South Main St.. South Det- fl ld 0127
(N0.) (STREET) (CONTR'S LICENSE)
Addition One Family NUMBER OF � k�smnn[
PERMIT TO (_) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION)
182 North Maple Street, Florence D ZONING STN CT MB
(N0.) (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 CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
permit is to add upper story bed extend living/family room and 300 sq. ft. open deck
REMARKS:
AREA OR 320 sq. ft. �` 23 000.00 PERMIT 70.40
VOLUME ESTIMATED COST FEE
(CUBIC/SQUARE FEET)
Thomas & Cynthia Dourmashkin
OWNER B L L�4
ADDRESS 182 North Maple Street Florence BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY ■ PINK - A SESSORS COPY p0.11'