17A-251 (2) 11 1
Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR 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.
Owner or i/
Lessee S ��
Builder's
2. SA IF 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.
SigruaTur of applico/f't Address Application date
koF
a '
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
q Fee Started y Approved y
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check 0btai ed 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 FOR DEPARTMENT USE ONLY
Permit number
Building. Use Group
Permit issued f 19
Building �j+) Fire Grading
Permit Fee $ 0 Live Loading
Certificate of Occupancy $ Occupancy Load
ed by:
Drain Tile $ t
Plan Review Fee
TITLE
- CITY OF NORTHAMPTON
�• MASSACHUSETTS r
OFFICE of t INSPECTOR of BUILDINGS
IVT Page � Plot 5�� APPLICATION
FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
? ZONING
AT (LOCATION) 17 / DISTRICT
LOCATION (NO.) r (STREET)
OF BETWEEN g l! )! s f AND OAK %*4
BUILDING (CROSS STREET) CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vr
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE – For"Wrecking" most recent use rn
M
1 New building Residential Nonresidential
2 Addition(1/ residential, enter number 12 One family 18 Amusement, recreational
of new bousing units added, if any,
in Part D, 13) 13 Two or more family – Enter 19 Church, other religious
number of units– – – – > 20 Cl Industrial
3 � Alteration (See 2 above) 14 n Transient hotel, motel,
4 Repair, replacement 21 Parking garage
or dormitory – Enter number
5 Wrecking (If multifamily residential, of units ––––––– – -- 22 Service station, repair garage
enter number of units in building in 15 Garage 23 Hospital, institutional
Part D, 13)
16 Carport 24
6 Moving (relocation)
LJ Office, bank, professional
n
17 Other – Specify 25 �� Public utility
7 Foundation only 26 n School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 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,,,,,,,,,,,,,,,, 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 is G
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 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 D 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 .......................
35E] Gas Will there be central air 52. Outdoors........................
36 n Oil conditioning?
� L. RESIDENTIAL BUILDINGS ONLY
�37 C-� Electricity 44 Yes 45 `77 No 53. Number of bedrooms..............
38 Coal
39 Other – Specify O Will there be an elevotor? Full..........
S4. Number of
46 Yes 47 No bathrooms
`— Partial.......
Department of Building Inspections
212 Main Street _,,, A
Northampton, Mass. 01060 BUILDING o° // / , O'D PERMIT c''
17A - 251
VALIDATION
DATE April 24, ig 84 PERMIT NO. 157
APPLICANT Paul E. Lentz ADDRESS 112 Lake Street
(NO.) (STREET) (CONTR'S LICENSE)
New Building Garage NUMBER OF
PERMIT TO g (�) STORY g DWELLING UNITS _
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
114 Lake Street ZONING URB
AT (LOCATION) DISTRICT
(NO.) (STREETI
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE 24 FT. WIDE BY 24 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: permit for the construction of a new garage on the left rear of eixsting one family
home
AREA OR 536 sq. ft. 1,500.00 PERMIT 10.00
VOLUME ESTIMATED COST $ FEE
(CUBIC/SQUARE FEET) "
Paul & Susan Lentz
OWNER
Lake Street BUIL
ADDRESS BY
WHITE - FILE COPY GREEN - FIELD COPY a CANARY - APPLICANT COPY • PINK - ASSESSORS COPY