05-024 (3) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
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NOTES
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Nome Mailing address — Number, street, city, and State ZIP code Tel. No.
owner orot
Lessee � �ios-,,37
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.
Signatur f applicant ' Address Application dote
/ 41-tAV41, /I
DO 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 $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number B Permit or Approval Check Date Number B
Obtained y pp 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
c1.(.
Building. Use Group
Permit issued a Z11 19 .j
Building Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
A r ed by:
Drain Tile $ '
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
.� MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
t Page Plot �� APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORT/AN/T -- Applicant to complete all items in sections: I, 11, 111, IV, and IX. C1
ZONING
I. ". 1L / / ' Vl.C• %I/U (� [ft DISTRICT .
AT (LOCATION)
LOCATION (NO.) (STREET) p/)
OF BETWEEN "L'7 /E-19 AND Rl:, -Y)C�
BUILDING (CROSS STREET) (CROSS STREET)
LOT aj t'; •1
SUBDIVISION LOT BLOCK SIZE,
-1
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
1 l�'New building Residential Nonresidential
2❑ Addition(If residential, enter number 12❑ One family 18 ❑ Amusement, recreational
of new housing units added, if any, 13 ❑ Two or more family - Enter 19 ❑ Church, other religious
in Part D, number of units- - - - --I
3 ❑ Alteration (See 2 above) 20❑ Industrial
14 Transient hotel, motel,
4 Repair, replacement 21 ❑ Parking garage
p p 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) ❑
16 Carport 24❑ Office, book, professional
6❑ Moving (relocation)
17 Other - SpeciJy_iSARPGA) 25 ❑ Public utility
7 Foundation only
_ 26 ❑ School, library, other educational
���': /�r` �l
B. OWNERSHIP 27 Stores, mercantile❑
8 ® yPrivate (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 E acs in
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 Q Wood frame 41 ❑ Private (sq ?ic top k, etc.) 49. Total square feet of floor area,
all floors, based on exterior
- a
32 ❑ Structural steel e!)/L° dimensions ..................... lC
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY'
34 ❑ Other - Specify 42 ❑ Public or private company 50. Total land area, sq. ft. ........... a'20
43 ❑ Private (well, cistern," K. NUMBER OF OFF-STREET
/jON 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 Electricity 44 Yes 45 " No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other - Specify Will there be an elevotoO Full..........
-" 54. Number of _
46 ❑ Yes 47 M No bathrooms
Partial........
DEPT. OF BUILDING INSPECTIONS BUILDING �O
! 212 Main Street f a !
Northampton, MA 01060 PERMIT
5 - 24 p VALIDATION
DATE May 24, _19 85 PERMIT NO. 284
APPLICANT Ronald Korza ADDRESS 264 Audubon Road Owner
(N0.) (STREET) (CONTR'S LICENSE)
PERMIT TO Garden Shed (,) STORY One Family NUMBER OF
UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
KK
AT (LOCATION) 264 Audubon Road ZONING
DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE 10 FT. WIDE BY 12 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: permit ofr the construction of a new 10' x 12' garden shed
AREA OR VOLUME 120 sq. ft. -ESTIMATED COST .$ 600.00 PERMIT $ 10.00
(CUBIC/SQUARE FEET) '"� //
OWNER Same as Applicant
ADDRESS Same as X Applicant's BYIL T �
� -� 'h��%s
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - AS ESSORS COPY pOlp