25C-081 (3) ZONING •
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
1.
Owner or
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 of applicant Address Application date
00 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 Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number By Permit or Approval Check Date Number B
Obtained 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 uL, Ir-) �_ 19
Building Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
A d-bX:
Drain Tile $ ---
Plan Review Fee $ i
T LE
CITY OF NORTHAMPTON
�. MASSACHUSETTS
e OFFICE of the INSPECTOR of BUILDINGS
Page — Plot f. 1 APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. C)
ZONING
I• AT (LOCATION) `�� DISTRICT
LOCATION (NO.) (STREE
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 ;0
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use rn
rn
1 ❑ New building Re i nIial Nonresidential
2 E] 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 – Enter 19 �� Church, other religious
number of units– – – – 20 Industrial
3 Alteration (See 2 above) 14 l, r
❑� !. � Parking garage
4 Transient hotel, motel,Repair, replacement or dormitory – Enter number
5 Wrecking (11 multifamily residential, of units ––––––– – -i 22 ❑ Service station, repair garage
enter number of units in building in 15 L❑ Garage 23 Hospital, institutional
Part D, 13)
16E] Carport 24 L_� Office, bank, professional
6 �� Moving (relocation)
17 ❑ Other – Speci/y 25 ❑ Public utility
7 Foundation only 26 School, library, other educational
B. OWNERSHIP 27 L❑ Stores, mercantile
8 Private (individual, corporation, 2B ❑ 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................ /!/L/( 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 7 L If use of existing building is being changed, enter proposed use.
in the above cost p�,
a. Electrical..................... b'Z—pwtz L -t
b. Plumbing .......................
c. Heating, air conditioning..........
s
d. Other (elevator, etc.)............. V �)',,
11. TOTAL COST OF IMPROVEMENT $~ X r C�
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L; / t
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 L❑ 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
J — -
Yes 45 No
37 E Electricity 44 53. Number of bedrooms..............
38 ❑ Coal
39 L__ Other – Specify Nill there be an elevators Full..........
54. Number of
46 � ] Yes 47 D No bathrooms
Partial.......
DEA. OF BUILDING INSPECTIONS BUILDING -z° 4 1c) - m
! 212 Main Street 0
Northampton, MA 01060 PERMIT
25C - 81 VALIDATION
DATE July 12, )��r-�- eP�tree�O' 435 Owner
APPLICANT Robert M. Zuraw ADDRESS
IND.) ISTREET) (CONTR'S LICENSE)
PERMIT TO Demolition/Addition (_) STORY One Family DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 321 Bridge Street ZONING URB
DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS 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 for the demolition of 2 existing porches on rear of dwelling i11t replace with deck
12' X 20' outside of first floor jod
VOLUME ESTIMATED COST $ XXXXX 900.00 FEFM'T , 10.00
(CUBIC/SQUARE FEET) �.
OWNER Sama AS Annl i cnnt j
BUILDING DEP
ADDRESS Same ac 661 icant' s BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASS,E'SSORS COPY I,'QfP