17C-307 (4) ZONING •
DISTRICT RIM.
FRONT YARD
SIDE 1
SIDE YARD
REAR YARD I
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 ', Number, street, city, and State ZIP code Tel. No.
O. / / �' QOD�a
Owner or
Lessee / y— ,v Ns �C �yt
1.
ly.. ��/� s �3 3 �L� �✓ �/4T1—'Ie' ! .1 SJ LBcenserN0. 0
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 p licont Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re uired Check Plan Review Date Plans B Date Plans B Notes
q Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Permit or Approval 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 / FOR DEPARTMENT USE ONLY
Permit number /
Building. Use Group
Permit issued _ 19
Building Fire Grading
Permit Fee $ ®a
Live Loading
Certificate of Occupancy $ Occupancy Load
Appro by:
Drain Tile $ `
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
� --77
,VT Page // (f Plot `��,� APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING /��,yQ',��/�{
• AT (LOCATION) �� / DISTRICl/�-'-'a
LOCATION ,o(NO.)
(STREET) / v }�
OF BETWEEN�` Qf U�(�iL L �3 AND Z'?p/l /D C',!_
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
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 ❑ New building Residential Nonresidential
2 ❑eAddition(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
5 (❑ Wrecking (If multifamily residential, of units ——————— — --*. 22 ❑J Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 Hospital, institutional
Part D, 13) 16 ❑ Carport 24❑J Office, bank, professional
6 ❑ Moving. (relocation)
17 ❑ Other — Specify 25❑ Public utility
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OVNEPrSHIP r/ 27 L] Stores, mercantile
8 ivat (iZi ual corporation,
28 C❑ Tanks, towers
non pro i tion, 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 $
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 dPublic or private company 48. Number of stories..............
49. Total square feet of floor area,
31 ❑Wood frame 41 ❑ Private (septic tank, etc.) all floors, based on exterior a
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 I. TYPE OF MECHANICAL 51. Enclosed .......................
35 ❑ Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 Lk�Electricity 44 ❑] Yes 45 , ' y0 53. Number of bedrooms..............
38 ❑ Coal
39 L_) Other — Specify Will there be an elevators Full..........
54. Number of
46 ❑ Yes 47 No bathrooms Partial........
Department of building Inspections
212 Main St.
Northampton, Mass, - -0c060 BUILDING '°-
O
4 PERMIT 04 IL
a
17C - 307 VALIDATION
DATE May 4, 19 84 PERMIT No. 181
APPLICANT NXXXXXXI W. Childs & D. izu a ADDRESS 13 S Ereet, Hatfield 014572
IN 0.) (STREET) (CONTR'S LICENSE)
Addition Famil y Room NUMBER OF
PERMIT TO (_) STORY DWELLING UNITS -
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
48 Lake Street, Florence o STR cr URB
AT (LOCATION) --
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Addition
XXOXTUIU IS TO BE 16 FT. WIDE BY 18 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
permit to construct a� Yrvw�lyx>m ` erl
REMARKS:
AREA OR 288 sq. ft. $ 9,000.00 PERMIT 45.00
VOLUME ESTIMATED COST ! F E
(CUBIC/SQUARE FEET) \..
OWNER William Mizula
ADDRESS
48 Lake St. , Florence, Mass. 01060 BYIL G r
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY