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17A-127 (11) Vill. ZONING PLAN EXAMINERS NOTES DISTRICT IX. 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Nr • N. uunuuuu.uN., NOUN .. • ■N. .. r■H. ...t• •• NNNan .t ■■ • H \•■ .N\ ./t•t.a.H, PRIME a !s�j a: : aaa • a. ■N •aa.aa.at: .ai:a•xtx■.:•\.■ .NN, a Ma aaa! ■r/: r s ss$ss$s:sa$aasasa:::, .••./.r.a•.■.■r:.•wns, tat .■...■.•...■■.t...t. . .s$aaa.. ....$$�a$.$ $ asasas$a: :a. ... ...... .... ...:...................., • •$ $ s • a :$ aaa:$= : '•••:• saa:::n:s:ss:::t::nine:a:::a, ��. :a . . .$ssi::ssaHUHI::aas HU g !! ii's_ :ism;ssse��: z ;�:•�lS:: ee::e:nut w-� 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. l'C Lessee -� - C f f J t Builder'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. Signature of pplicant Address �G / Application date G/ 171/v A 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 Permit or Approval Check ObDtaained Number By Permit or Approval Check Obtta t ed Number By BOILER PLUMBING CURB OR SIDEWALK CUT ROOFING ELEVATOR SEWER ELECTRICAL I SIGN OR BILLBOARD FURNACE STREET GRADES GRADING USE OF PUBLIC AREAS OIL BURNER WRECKING OTHER OTHER VII. VALIDATION Building J / FOR DEPARTMENT USE ONLY Permit number `Y Building Use Group Permit issued 19 f Building , f Fire Grading Permit Fee $ d "' Live Loading Certificate of Occupancy $ Occupancy Load Approved by:� Drain Tile $ ���'�'/e""�`"S � � • Plan Review Fee $ TITLE CITY OF NORTHAMPTON �+ MASSACHUSETTS r $ f OFFICE of the INSPECTOR of BUILDINGS t Page Plot APPLICATION FOR INSPECTOR ZONING PERMIT AND BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O •.. '^f,�� „. ,[y ZONING I• AT (LOCATION) �"�... k=,� DISTRICTS` LOCATION (NO.) (5TREET) O FC f `r AND J 1 1. L._. r --� BETWEEN {-- ---- BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK 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 ❑ New building Residential Nonresidential 20 Addition(/ residential, enter number / 12 F-1 One family 18 Amusement, recreational of new housing units added, if any, in Part D, 13) 13 Two or more family - Enter 19 n Church, other religious number of units- - - - --jo. 20 Industrial 3 D Alteration (See 2 above) 14 Transient hotel, motel, 4 El Re air, re lacement -- 21 Parking garage P P or dormitory - En[er number 5 El Wrecking (1l multifamily residential, of amts -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) 7 � Foundation only 17 �_� Other - Spec'/y 25� � Public utility 26 F] School, library, other educational B. OWNERSHIP 27 LJ Stores, mercantile 8 CJ 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,,,,,,,,,,,,,,,, J�`�'° 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 $ 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❑ Masonry (wall bearing) 40 Public or private company 48. Number of stories................ 31 [--] Wood frame 41 n 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 Public or private company 50. Total land area, sq. ft. .......... 34 Other - Specify 42 43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 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 j Electricity 44 Yes 457', No --. 53. Number of bedrooms.............. 38 Coal 39 Other - Specify Will there be an elevators Full.......... _ 54. Number of 46 [_, Yes 47 '_j No bathrooms Partial....... DEPT. Of BUIWING INSPECTIONS BUILDING z° �0/ x) , �)C) ! 212 Main Street 04 Northampton, MA 01060 PERMIT 17A - 127 VALIDATION DATE 1 )1 V 10 ER APPLICANT IT NO. 4;0 Richard Wanczyk a ADDRESS rl ge �toa� Owner (NO.) (STREET) (CONTR'S LICENSE) New Chimney One Family NUMBERNG OF UNITS PERMIT TO (_) STORY NO. (PROPOSED USE) Bridge Roa ZONING URA AT (LOCATION) 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: AREA OR 300.00 FEEMIT $ 10.00 VOLUME ESTIMATED COST , (CUBIC/SQUARE FEET) OWNER Same as Applicant ADDRESS Same as Applicant's BYI WHITE - FILE COPY P GREEN - FIELD COPY • CANARY ^ APPLICANT COPY • PINK ASSESSORS COPY PAINT P moommommmmmmmmommmommNOW