25C-014 (4) s,
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FRONT YARD
SIDE YARD SIDE YARD
IX. SITE OR . Applicant Use
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, strut, city, and State ZIP code Tel. No.
v ` ova 60 r 3
Owner or
Lessee
Builder's
License No.
2.
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 applicant Address Application date
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plan Review Date Plans B Date Plans Notes
Plans Review Required Check Fee Started y By Approved
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 / r l�l FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued 19 4)
Building Fire Grading
Permit Fee $ r Live Loading
Occupancy Load
Certificate of Occupancy $
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�
' MASSACHUSETTS
e OFFICE of the NSPECTOR of B ILDINGS
OT Page Plot 11 APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT�— Applicant to complete all items in sections: 1, 11, 111, IV, and IX. p
/ V
I• AT (LOCATION)_ !7 J l/Yt�IO� ��'`� '._ r� ,jc� arf• DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
SUBDIVISION LOT BLOCK LOT
SIZE
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
M
1 LgNew building Residential Nonresidential
2 ❑ Addition(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 — f'nter 19 ❑� Church, other religious
number of uni Industrial
ts— — — — 20
3 ❑ Alteration (See 2 above) ❑�
14 ❑ Transient hotel, motel,
4 ❑ Repair, replacement 21 L] Parking garage
or dormitory — Fnter number _
5 ❑ Wrecking (II multifamily residential, of units ——————— — -.� 22 L� 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)
7 ❑ Foundation only
17 ❑� Other - Specify 25 Public utility
26�❑ School, library, other educational
B. OWNERSHIP 27 L� Stores, mercantile
8 Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29❑J 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 machine u building t hri e .10. Cost of im p rovement,,,,,,,,,,,,,,,, schoolsecondary school college parochial 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....................... r-l-a-6ifele el
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�Mosonr g 48. Number of stories................
y (wall bearing) 40 ❑ Public or private company
31 Wood frame 41 Fil 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
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 ❑ Electricity 44 ❑ Yes 45 7l' No
--- 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will the•e be an elevotor�
— 54. Number of Full..........
__
46 r 1 Yes 47 ❑ No bathrooms
Partial.......
DEPT. &F BUft.DING INSPECTIONS
BUILDING
212 Main Street o< 7
Northampton, MA 01060 PERMIT <a
25C - 14
VALIDATION
DATE April 4, 19 88 PERMIT NO. 168
APPLICANT Arthur J. Zygmont ADDRESS 90 Woodmont Rd. Owner
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO NPw Rii ,A" (_) STORY nPtachPd Gara9P DWELLING UNITS
(TYPE OF IMPROVE NT) NO. (PROPOSED USE)
AT (LOCATION) 9n Wondmnnt Road ZONING URB
DISTR ICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE24 FT. WIDE BY 24 FT. LONG BY FT. IN HEIGHT AND SMALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: permit for the construction of a detached garage
AREA OR 576 sq. ft. ESTIMATED COST $ 5 500•00 FEE MIT 28.80
VOLUME
(CUBIC/SQUARE FEET)
Same as Applicant
OWNER ame as pp ican s BYILDI E � G
ADDRESS
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY • PINK - ASSESSORS COPY P'iRf' ' P