17A-248 (5) ZONING
FRONT DISTRICT
. .
SIDE YARD SIDE YARD
REAR YARD
IX. SITE OR PLOT
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NOTES and Data — (For department use)
Now
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — ;''umber, street, city, and State ZIP code Tel. t.'n.
Owner or
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 of applicant Address Application date
a
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 $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approva I Check Obfa tned Number By Permit or Approval Check Obtta t ed 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 �� FOR DEPARTMENT USE ONLY
Permit number
Bul Iding- Use Group
Permit issued 7" 19 _
Building / Fire Grading
Permit Fee $ ��/1 Live Loading
Certificate of Occupancy $ Occupancy Load
ved by:
Drain Tile $
Plan Review Fee $
TITLE
oA CITY OF NORTHAMPTON
4 MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
'"' Page Plot y�❑ APPLI CAT ON FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O
I• AT (LOCATION) ZONING
►L, r .��—�/�rR�t��1��
DISTRICT
LOCATION �°•' `STREET'
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
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 ❑ New building Resid ti al Nonresidential
2�Addition(If residential, enter number 12W One family 18 ❑ Amusement, recreational
Of neu' housing units added, if any,
in Part D, 13) 13 ❑ Two or more family - Enter 19 Church, other religious
i number of units- - - - -->. 20 Industrial
teration (.See 2 above) 14 ❑ Transient hotel, motel,
J 21Parking garage
4 pair, replacement or dormitory - Enter number
5 Wrecking (11 multi family residential, of units ------- - -i 22 ❑ Service station, repair garage
enter number of units in building in 15 Ej Garage 23 ❑ Hospital, institutional
Part D, 13) 16 ❑ Carport f 24 Office, bank, professional
6 ❑ Moving (relocation)
7 ❑ Foundation only 17�Other - Specify 25 �� Public utility
7� 26 ❑ School, library, other educational
B. OWN SHIP 27 E] Stores, mercantile
8 Private (individual, corporation,
N 28 ❑ Tanks, towers
nonprofit institution, etc.) 9N 29 `❑ Ot-herr - Specify
9 L❑ Public (Federal, State, or J
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
o. Electrical.......................
b. Plumbing .......................
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $
III. SELECTED CHARACTERISTICS OF ETUILDING — 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 ❑i Masonry (wall bearing) 40�Public or private company 48. Number of stories................
31 Wood frame 41 I J 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
S cci 42 Public or private company 50. Total land area, sq. ft.
34 I -1 Other - p' f.' P P Y
43 E❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed .......................
35XGas Will there be central air 52. Outdoors........................
36' Oil coXan
�- L. RESIDENTIAL BUILDINGS ONLY
37 ! Electricity 4 4 No 53. Number of bedrooms..............
38 �� Coal 39JOther - Specify WiFull.........54. Number of 46 No bathrooms- Partial.......
_,._.. _.-..�r .�.,��� �.�,...� _�_�,-�..,.-.w„�., ,�
t
.,
?..
Depar` eat of Building Inspections
212 Ma Street BUILDING o° Av>
No xt�h (. Me. 01060 �ERM1T
17�t - 2J® VALIDATION
J.114 &�FC7 DATE Hit 27, 19 Ai -PERMIT NO.
APPLICANT Ann M, Knc_1nsk4 _ ADDRESS 93 j+nka
,. (NO.) (STREET) (CONTR'S LICENSE)
µ
PERMIT TO AdA T NUMBER OF _
mnt�.t,t ,g(°,g, ,,, (_N) STORY DWELLING UNITS
(TYPE OF MPRO MENT) N0. .(PROPOSE USE)
ZONING � )
AT (LOCATION) DISTRICT
(NO.) (STREET)
BETWEEN ND
(CROSS STREET) (CROSS STREET)
LOT
SV8D'1VtS1ON LOT BLOCK SIZE
AM tion
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!'
REMARKS: 1 i! atcuctaza
make pouh. v replacin' existing storage shed with new cane, 8' X 8 .
VOLUME ESTIMATED COST $ 750-00 PER $ to no
(CUBIC/SQUARE FEET)
OWNER Edward Raclaski �
BOIL gN
ADDRESS-98 fake AW-ast 1P1 air �._,� ��e 01060 BY
WHITE - FILE COPY . GREEN - FIEM COPY CANARY - APPLICANT COPY PINK - A ESSORS COPY
Department of Building Inspections g UIL DI N G Z°
°12 Main Street oO<
' orthamptlin, Ma. 01060 PERMIT <a
17A - 248 VALIDATION
DATE May 27, 1991 PERMIT NO. 243
APPLICANT Ann M- Kncinekj ADDRESS 98 T aka
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF 1
PERMIT TO A[�[�;t�n� r�I aCt(-2—) STORY nn�_rr}�rstora�e shed DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOS�USE)
ZONING OR
(LOCATION) 98 Lake DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Addition
XXXM IS TO BE R FT. WIDE BY $ FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
1 1
REMARKS:
make porch. , replacing existing storage shed with new one, 8' X 8'.
AREA OR ESTIMATED COST $ 750-00 FEEMIT $ 10-CIO
VOLUME
(CUBIC/SQUARE FEET)
OWNER Fdward Koc4m- 4 BUI 1
Take ADDRESS QR Sure Flo-once, Ma, 9�0�0 - BY
WHITE - FILE COPY , GREEN - FIELD COPY • CANARY - APPLICANT COPY a PINK - A SESSORS COPY