23A-016 (14) rirbP) DEPT. OF BUILDING INSPECTIONS BUILDING i9 S j 4/i1 A60
212 Main Street 0 4
Northampton, MA 01060 PERMIT ST <
1.
4
23A — 16 VALIDATION
DATE July 15, 19 86 PERMIT NO. 382 Owner
Justin Stone ADDRESS 14 Park St. Florence Owner
u0.1 WIRER ICONTR•s LPCFNSEI
PERMIT TO Addition I_) STORY Lean-to onton existing b]g BERWELLN aDNITs
OUTS OF IwAOVEMCNR Na IMPASSES list:
AT ILOCAT ION)
14 Park Street ZONDISTINN CT IIR8
(Na,) ItTREETI
BETWEEN_ AND
{CROSS STREET) Itanns 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
MAAR
REM.RNEI permit for the addition of a lean-to to be used for storage area; onto existing
a LI.UL.LUL e
AREA ORERM
y� 150.00 PIT y. 10.00
VOLUME ESTIMATED COST $ FEE y)
I CUEIC/SQUARE RET)
Same as Applicant
OWNER BUILDING q
ADDRESS Same as Applicant's BY 3'
WHITE - FILE COPY • GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK ^ ASSESS .. COPY per
tit;�J' , CITY OF NORTHAMPTON
( lithe
MASSACHUSETTS
,1OFFICE of INSPECTOR of BUILDINGS
t' A � Plot` •;:> Page C/
.y- APPLICATION FOR
ZONING PERMIT ANE
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, II, III, IV, and IX. O
/(4/ ✓`
AT (LOCATION) yn �� C r--- DISNTRICact
T .
LOCATION INO.1 {STREET)
OF BETWEEN AND
BUILDING (CROSS STREETI (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D —I
A
A. Tl(PE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use III
�, I m
Ne.. building Residential Nonresidential —11
21 I Addition(If residential, enter number 121 I One fondly IB Li Amusement, recreational
of new h D.
1units added, if any, 13 Two or more family — Enter 19Church, other religious
innew D, 13) Li
number of units— — — — y 201 ( industrial
3 I I Alteration (See 2 above) 14 n Transient hotel, motel, -�
4 I Repair, replacement or dormitory — Enter number 21 LJ Parking garage
5 I Wrecking !II multifamily residential( of units — y 22 1 I Service station, repair garage
enter number o/units In building in 15 1 I Garage 23 L i Hospital, institutional
Part D, 13) 161 1 Carport 241 I Office, bank, professional
61 r I Moving (relocation)
7Foundation only 17 I Other — Specify 25 it Public utility
S �`.S G1= 26 n School, library, other educational
B. OWNERSHIP + 27 n Stores, mercantile
8 1s4Private (individual, corporation, —
29 LiTanks, towers
nonprofit institution, etc.) 29 r� Otherrhe. — Sped/y /
9 til Public (Federal,
State, or
k C /WRIR
local government)
C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings,e.g., food
processing plant, machine shop, laundry building al hospital, elementary
10. Cost of improvement S /Sd 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 )
II. 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
48301 Masonry (wall bearing) 40 Li Public or private company Number of stories
31 Wood frame 41 Private (se tank, etc.) 49. Total square feet of floor area,
reflood L pitall floors, based on exterior
32 I I Structural steel dimensions
331 I Reinforced concrete H. TYPE OF WATER SUPPLY
50
34 I 1 Other — Spen/y 421 I Public or private company Total land area, sq. 0
43 nJ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL St Enclosed
351 I Gas Will there be central air 52. Outdoors
36 n Oil conditioning' L. RESIDENTIAL BUILDINGS ONLY
37 i_1 Electricity 44 r i Yes 45�. No 53. Number of bedrooms
381 I Cool
391.7I Other— Sperify Will there be on elevator' { Full
54. Number of
46 n Yes 47 I-1 No bathrooms parr al
IV. IDENTIFICATION - To be completed by all applicants
Name Mailing address - Number, street, env, and State ZIP code Tel. No.
owes,
or
_USI"ryt S Cne i5` f/l�i'1 l7 Cr matt i hec 0/040 Snit 4.035-•
Lessee
By lde;s
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.
sign. u of applicant Address Application date
�e /1 , r, ilic�w 7-9 -:f 6
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
P tans Review Required Check Plan Review Date Plans ByDate Plans ByNotes
quire Fee Started Approved
BUILDING $
PLUMBING •
$
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
DPermit or Approve I CheckOVALS
aDD Number By Permit or Approval Check Obsa alned 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 QQ �' Use Group
Permitlds .�issued �A..I � I 19 (Nen
Building Fire oroig
1 .11/
Permit Fee $ Live Loading
Certificate of Occupancy $ Occupancy Loud
Approved by: //��
Drain Tile $ 429
/J
//
Plan Review Fee $
TITLE
tal°1
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NOTES and Data — (For deportment use)
VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use +,
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