17D-059 ZONING •
FRONT YARD
SIDE • . .D
REAR YARD
NOTES
IX. SITE • ' PLOT PLAN For . •7�1
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — A'urabc•r, str,,c•t, city, u IrlStrtc, ZIP code Tel. No.
1 _
JIMOwner or
Lessee ul
Builder's
L.
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 applicat*on as his authorized ent and we agree to conform to all applicable laws of this jurisdiction.
Signature of app I' Address Application date
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re wired Check Plan Review Date Plans B Date Plans B Notes
9 Fee Started y Approved y
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER � -- -- .--- —
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date 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
Permit number
Building
Permit issued `�,/! 192_
Building
Permit Fee $
Certificate of Occupancy
AppVY'
Drain Tile
Plan Review Fee s—
TITLE
Crity of Xort4ampton
� � �lxssaclptsetfs
T Offire of the �nsvertor of 'Ouilbings APPLICATION FOR
ZONING PERMIT AND
Page Plot � BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. p
ZONING
I• AT (LOCATION)
DISTRICV,&R
LOCATION ("0•) (ST RE j )
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 7�0
m
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
1 ❑ New building Residential Nonresidential
2 ❑ Addition(If residential, enter number 12❑ One family 18 ❑ Amusement, recreational
of new bousing 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 ——————— — -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, bank, professional
6 ❑ Moving (relocation)
17❑ Other — SpeciJy 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 (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 .....................
r
c. Heating, air conditioning..........
t
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. y
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS D
m
30❑ Masonry (wall bearing) 40 ❑ Public or private company 48• Number of stories..............
31 F-1 Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square feet floor area,
all floors, based on exterior
32 ❑ Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other — Specify 42 F—] Public or private company 50. Total land area, sq. ft. ..........
43 �❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed ...................... 1"
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL O
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 elevator? 54. Number of Full..........
46 ❑ Yes 47❑ No bathrooms
Partial........
I hereby certify that the proposed w rk is authorized by the owner of record
and I have been authorized by the owner to make this applicat on 'as his
authorized agent.
SIGNATURE OF AGENT -"
ADDRESS
(NUMBER) (5 REET) (CITY)
APPROVED BY _ TITLE
DATE 19
Zo
DEPT: FILE COPY
. .
C'SFY OF NORM N BUILDING 0a
NpRTHANlF`. m&. o1o6p 17D _ 59 PERMIT VALIDATION
DATE March 28, 197_ PERMIT NO. 62
APPLICANT aryille menard ADDRESS 23 Garfield Avenue
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO DOWlltiOn (_) STORYCabin & Att. bus DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONINGS
AT (LOCATION) 23 Garfield A4e32iiE DISTRICT
(NO.) (STREET)
a BETWEEN AND
(CROSS STREET) (CROSS STREET)
IL LOT
m SUBDIVISION LOT BLOCK SIZE
a
0 BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
I (TYPE)
o REMARKS: Demolition of oyerni ht cabin & attached railmAy bus
AREA OR 1' PERMIT
VOLUME ESTIMATED COST $ 2,940.00 FEE $ 10.00
(CUBIC/SQUARE FEET)
OWNER Orville Menard
ADDRESS 25 Garfield Avenue BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)