17C-229 (20) ZONING
DISTRICT
FRONT YARD
SIDE YARD SIDE - .
NOTES
IX. SITE OR PLOT
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — .vt,mhcr, sircci, city, rna! Stutr' ZIP code Tel. No
()caner or Yr I �` i . J .�" .>� � ,� ��5f�12..�G
Lessee
r
Builder's
License No. .1 4/2-C",6
Contractor f
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.
Signs, re ofnt ,,' Address ' Application date
0 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans Date Plans
Fee Started By Approved By Notes
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER
Vi. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
royal Date Date
Permit or A
pp Check Obtained 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
Permit number 7,3
Building
Permit issued 19 ZZ
Building ---T
Permit Fee $ % al:,
Certificate of Occupancy
Approve
Drain Tile S _ Pt � a
Plan Review Fee S—
TITLE
of Xort4ampton
� � �IMSS�lclptsetts
(Office of the �ns}lertor of Auilbinps
APPLICATION FOR
ZONING PERMIT AND
Page j (- Plot Z c BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. ` p
ZONING
AT (LOCATION)
LOCATION (Na.) STREET
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
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
1 ❑ New building Residential Nonresidential
2 F-1 Addition(11 residential, enter number 12❑ One family 18 Ej Amusement, recreational
of new housing units added, if any, 13 ❑ Two or more family - Enter 19 Church, other religious
in Part D, Se number of units- - - - -�
20� Industrial
3 Alteration (See 2 above) 14 Transient hotel, mote ,
❑ T h l l 210 Parking garage
4 ❑ Repair, replacement or dormitory - Enter number
5 ❑ 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
6 0 Moving (relocation)
7 � Foundation only 17❑ Other - SpeciJy 250 Public utility
26 [:] School, library, other educational
B. OWNERSHIP 27 i Stores, mercantile
8 Private (individual, corporation, 28 ❑ Tanks,'towers
nonprofit institution, etc.) 29M 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, secondar y 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 existing building is being changed, enter proposed use.
in the above cost
a. Electrical.....................
b. Plumbing ....................... �/ 1
c. Heating, air conditioning..........
d. Other(elevator, etc.)............
- -:;rf•
11. TOTAL COST OF IMPROVEMENT $
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and odditions, complete Parts E — L;
for wrecking, complete only Part J, for all others skip to IV, y
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS 17
m
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
F. PRINCIPAL TYPE OF HEATING FUEL 1. TYPE OF MECHANICAL 51. Enclosed ....................... r-
0
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
39E:] Other - Specify Will there be an elevator? 54. Number of Full..........
46 ❑ Yes 47E] No bathrooms
Partial.......
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AM 71
After .
TF
54 k
f
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S 3rd 3" r
hereby certify that the proposed work,is authorized by thle, owner 9j ryec.Qrd-,, -
and I have been authorized by the owner to`make this application as his
authorized agent.
SIGNATURE OF AGENT `
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE }g _
DEPT. FILE COPY
z
City or Northampton BUILDING
Northampton, Ma. 01060 17C - 229 PERMIT VALIDATION
DATE April 10, 1978 PERMIT NO. 93
APPLICANT William — Woad ADDRESS 26 DB i Re
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Al ter W rehoLSe (_) STORY W rehoLe® DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) 28 bb Maple treat DISTRICT ST
(NO.) (STREET)
a BETWEEN AND
m (CROSS STREET) (CROSS STREET)
a
LOT
a SUBDIVISION LOT BLOCK SIZE
m
U
O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
I
It
° REMARKS: Install glass doors install partition 12 X 12
AREA OR ESTIMATED COST $ 2500.00 FEEMIT $ 104.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER riklAirwanti Raalition - BUI
ADDRESS 10 Mn Streets, Fl.orence1 Ma` BY 1
(Affidavit on reverse side of application to be completed by authorized agen of owner)
oil