07-027 (5) — — DEPT. nix wr R
DEPAR'£4ENT OF BUILDING INSPECTIONS BUILDING
co
CITY OF NORTHAMPTON F•
212 MAIN Ste' Cn PERMIT
NORTHAMPTON, MA. 01066 7-27 VALIDATION
NORTHAMPTON, DATE November 24( is TB PERMIT NO. syn•
APPLICANT Leonard C Jekanowskj ADDRESS • 1• I 'Y_- rags :I.
01O.1 (STREET) {COXtR'S lJ FESSE)
NUMPERMIT TO Altar Rwni r1Pnn Residence DWELLING
OF
(TYPE or IMPROVEMENT) 1 ) STORK {PROPOSED USE) GWELLIHG UNIT$
AT (LOCATION)._._ 549 North Faits Road _ _—D s'TP ICT BR
(No.) (STRUT
BETWEEN AND
••
(CROSS STREET) (CROSS ETREET)
LOT
a• SUBDIVISION LOT BLOCK SIZE
p BUILDING 1S TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
D
t TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
F (TYPE)
• REMARKS: Foundation alteration k mise. ren#Idl 1 w p 5 pE
VOLUME ESTIMATED COST $ Don FEEMIT $_ 15 (10
(CUBIC/DOUARE FEET
OWNER LPonaivl C .Fes+nosmk-i EVIL "C +{/P!. � /
ADDRESS 549 North Farms Rd. BYi v _
/Affidavit on reverse side of application to be completed by as i ed agent of owner)
I hereby certify that the proposed work is authorized by the owner of record
and I have been authorized by the owner to make this application as .his
authorized agent.
SIGNATURE OP AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 14
CITY OF NORTHAMPTON
f-ce
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET l- APPLICATION FOR
NORTHAMPTON, MA. 01060 PLAN EXAMINATION AND
BUILDING PERMIT
IMPORTANT - Applicant to complete all items in sections: I, II, Ill, IV, and IX. RR o
AT (wcnn onlJ�, �0 r��� l�R r )tt S /< D 0.�. DISTRICT /1 /�
LOCATION (No.) (STREET]
OF BETWEEN AND
BUILDING (CROSS STREET/ (CROSS STREET/
LOT
SUBDIVISION LOT BLOCK _ SIZE
cel
II. TYPE AND COST OF BUILDING - All applicants complete Parts A - D -I
A
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use In
In
-i
1 I I New building Residential Nonresidential
21 I Additi on(1/ residential, enter nrm+ber 121,N1 One family IB [f Amusement, recreational
of new housing units added, if any,
In Part D,. 13J 13 I 1 Two or more family — Enter 19 1 1 Church, other religious
number O/ursits- - - - -i 201-1 Industrial
3 Alteration (See 2 above) 14 Transient hotel, motel, 21 ri Parkin
4 I [ Repair, replacement or dormitory — Enter number 9 garage
51 1 Wrecking (If multifamily residential, of units - y 22 1 I Service station, repair garage
enter number o/ units in building in 15 1 [ Garage 23 fl Hospital, institutional
Part 0, 13)
6 Moving (relocation) 16 [ Carport 24 1 I Office, bank, professional
1z, Other — Specify 251 I Public utility
T 1 I Foundation only
/' 261 I School, library, other educational
B. OWNERSHIP� r ' 'dE i ^ . r'I t 3 . 27 I l Stores, mercantile
B. I Private(individual, corporation, /, 28 El Tanks, towers
1
nonprofit )
institution, ec.) dT t-F • t 291 I Other — Specify
9 1 I Public (Federal, State, or Y> /% /, g c .
local government) "" / 11tie
C. COST (Omit cents) Nonresidential - Describe irdemu proposed use of buildings,e.g., food
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement g re h— 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 $ Sr Ca D —
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 •
48.30 LJ Masonry (wall bearing) 40I I Public or private company Number ala �-?_
31 Wood frame 41X Private (septitank, etc.) 49. Total square feet of floor area,
5�'l all floors, based on exterior
32 1 I Structural steel dimensions
331 Reinforced concrete H. TYPE OF WATER SUPPLY /
341l Other — Specify 42❑ Public or private company Total land area, sq.ft
43 VI Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed
35 n Gas Will there be central air 52. Outdoors
361 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 n Electricity 441 I Yes 45 VI No 53. Number of bedrooms j
as 11 y�I Coal
Ir
39 Other- Specify Q) o O rf Will there be an elevator? 1 Full 1
54. Number of
461 I Yes 47 J No bathrooms
Partial
NOTES and Data — (For department use)
�/
/�/f I.42
/
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — ,vmrzbe., snrre, ray, and Warr ZIP code Tel No.
I' (e�PNArtI C S4 9 /Jo r--/-1, F.. � , 6T4 .677g
Ow er or /
Lessee 7�'anea. C. 14 /Jet l F. , . -lp .��T (4L$ ri /O .,
t, Builders
2. VI I�(p "C Qtr n t { � ?r - 1, A' t-h..- License No.
Contractors 1 I
7V. /a ✓4 /v'1 it-1{IA tee t, i�lt 1
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 th-srapplication os is authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signator of arppl cont y Address /4
Application date
:M,;_ ,+ � . /gin r J 1. �` •. Jia. , 11 —r-�,. —78
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Dote D
Permit or Approval Check Obtained Number By Permit or Approve I Check Obtttned Number By
a
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 \`IT--.
Building use Group
Permit issued )iQ-,.v jr V 19 ye
PerF $ /
Fire Grading
Permitg
Fee Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $ • 7 / r'
2
TIT
' C
J TIT
VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
�- /
r'_ '
USE
L � i',4
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN For Applicant Use
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90CA FORM APEBP - 669 01989 BIIILOING OFFICIALS 8 C066 ADMINISTRATORS INTERNATIONAL INC.