17A-226 (3) Vill. ZONING PLAN EXAMINERS NOTES
REAR YARD
IX. SITE OR PLOT PLAN For Applicant Use
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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.
(]weer or
v, Rbrc vu-,—c 09L,
Lessee a 1
2. Tt �t �� LBcenserNo.
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 s his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature of pplicant Address Application date
FRU 51. 4OV44�pt"T-- —Ovd, )q was 8,V
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 $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date D
Permit or Approval Check Obtai e a d Number By Permit or Approval Check 06t t ed 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 �! i�; FOR DEPARTMENT USE ONLY
Permit number
Building j r Use Group
Permit issued /�� 19
Building C) Fire Grading
Permit Fee $ `j tC�
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�. .e MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
Page -15;M 17A Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O
jr► ^ ZONING
I• AT (LOCATION) 7i �` J 1 DIISTR CT LOCATION J p (NO.) `/s i (STREET) JJJJ
OF BETWEEN 0A)M `—`,` AND N['), �'K` ��
BUILDING (CROSS STREET) JCROS STREET)
LOT
SUBDIVISION LOT A2 6BLOCK SIZE c2q C06 54 vFM
Vr
11. 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
1 ❑ New building Residential Nonresidential
2 Addition(I/ 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 – 1`nter 19 n Church, other religious
number of units– – – – 20 n Industrial
3 Iteration (See 2 above) 14 Transient hotel, motel,
e air, replacement � ------ 21 Parking garage
4
p p or dormitory – En[er number
5 Wrecking (1/multifamily residential, of units – – -� 22 Service station, repair garage
enter number of units in building in 15 n Garage 23 r Hospital, institutional
Part D, 13)
l 16 r art 24 �_� Office, bank, professional
6F–] Moving (relocation) L J p
17 LYE Other – Specify �� 25 n Public utility
7 Foundation only
26 School, library, other educational
B. OWNE SHIP ) — ILI 27 Stores, mercantile
8 Private (individual, corporation, � 't" 28 n Tanks, towers
nonprofit institution, etc.) • '\1 29 n Other – Specify
9 D 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•,••••,•,,,•,,,• 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....................... ti dC�
b. Plumbing ....................
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
it. TOTAL COST OF IMPROVEMENT $17,53 1
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. TYP7 SEWAGE DISPOSAL J. DIMENSIONS
30� Masonry (wall bearing) 40 Public or private company 48. Number of stories..............
31 Wood frame 41 M 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�2F WATER SUPPLY
34 Other – .Specify 42 Public or private company 50. Total land area, sq. 4t. ..........
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 '---1 G s conditioning?Will there be central air 52. Outdoors........................
36 � Oil L. RESIDENTIAL BUILDINGS ONLY
37 j Electricity 44 r� Yes 45
No 53. Number of bedrooms..............
38 Coal
39 Other – SPcci/y Will there be an elevators Full..........
– _ 54. Number of
46 [_� Yes 47 o bathrooms
Partial........
DeVT. OF BUILDING INSPECTIONS BUILDING z°
! 212 Main Street Oa
Northam�Aon, MA 01060 PERMIT
VALIDATION
q DATE May 26 )g 88 PERMIT NO. 360
&
APPLICANT D. L. Contracting Inc. ADDRESS Pleasant 016±121
(NO.) (STREET) (CONTR•3 LICENSE)
Wreck/Re air One family porch NUMBER of
PERMIT TO p (_) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
117 Lake Street Florence ZONING URB
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: Permit to wreck and remove 2nd story porch and replace it.
AREA OR ESTIMATED COST $ 3703.00 FEE PERMIT $ 16.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER
Mrs. A. ZiomekQ �"`
ADDRESS
117 Lake Street BYILDING DEPT
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY • PINK - ASSESSORS COPY p}NT IIP