17D-050 (7) ZONING ,
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address r Number, street, city, and State ZIP code Tel. No.
1. fS ` /��� (-)/ o G
Owner or L-4, 0 V19 D6
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 f applicant Address Application date
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Rev y iew Date Plans B 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 By or Permit Approval l Check Date Number B
Obtained 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
Building Use Group
Permit issued L4iA " 19
Building \\ Fire Grading
Permit Fee $ lo J
Live Loading
Certificate of Occupancy $ Occupancy Load
$ Approved by:
Drain Tile
Plan Review Fee
ITLE
i
CITY OF NORTHAMPTON
9• .� MASSACHUSETTS -
f OFFICE of the INSPECTOR of BUILDINGS
Page Plot !„ APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, III, IV, and IX. C)
ZONING 1
I• AT (LOCATION) '"/ 4 �� ' 1 �J DISTRIC
LOCATION /�(R ')//� ( (STREET)
OF - /'�'/u- r/ j S T AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D ;0
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
m
1 ❑ New building Residential Nonresidential
2 ❑ Addition(It 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, 13)
number of units- - - -> 20 ❑ Industrial
3 Alteration (See 2 above)
14 Transient hotel, motel, L
21 L� Parking garage
4 ❑ Repair, replacement or dormitory - Enter number
o/ units 22 ❑ Service station, repair garage
ts ------- - -i
5 ❑ Wrecking (!/multi/amily residential, Hospital, institutional
enter number of units in building in 15 ❑ Garage ❑23 Hos p
Part D, 13)
16 ❑ Carport 24 ❑ Office, bank, professional
6 ❑ Moving (relocation)
17 ❑ Other - Speci/y 25 ❑ Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP 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 (Om t cents Nonresidential - Describe in detail proposed use of buildings, e.g., food
Ilse 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 ! , ``i R
a. Electrical..................... �� �'� `�A/C
b. Plumbing .....................
c. Heating, air conditioning..........
d. Other(elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $
III. SELECTED CHARACTERISTICS OF BUIL ING — 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 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 ❑ 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 C❑ Other - Specify Will there be an elevoto0 Full..........
- 54. Number of
46 [-1 Yes 47 I❑ No bathrooms
Partial.......
a DEPT. 6F BUILDING INSPECTIONS
BUILDING
212 Main Street Oa
Northampton, MA 01060 PERMIT <a
17D - 50 VALIDATION
DATE January 24, 19 89 PERMIT NO. 55
APPLICANT Rirhard Nadolski ADDRESS 96 Straw Ave. , Northampton wner
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO (_) STORY Two Fami 1 v DWELL NG UNITS
P 0 MP VEMENT) N0. (PROP !ED USE)
AT (LOCATION) 96 r a W /P ZONING URB DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) ICROl3 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)
REMARKS, permit to weatherize existing front porch
AREA OR 2,000.00 PERMIT 10.00
VOLUME ESTIMATED COST $ FEE $
(CUBIC/SQUARE FEET)
OWNER Same as Applicant BUILDING DE
ADDRESS Same as Applicant's BY f-
WHITE - FILE COPY . GREEN - FIELD COPY a CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pOP