17A-278 (11) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
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BOCA FORM APEBP — 669 01969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
ai- :•. ..�z 1 i �.r
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
y-� 7-7f
00 NOT WRITE B E L 04 THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
9 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Dote
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 FOR DEPARTMENT USE ONLY
Permit number
Building _.� J 7 Use Group
Permit issued '' �9'
Building Fire Grading
Permit Fee $ C'c Live Loading
Certificate of Occupancy $ Occupancy Load
A , ed by:
Drain Tile $
'Pa rf �
Plan Review Fee $
TITLE
NOTES and Data — (For deportment use)
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 ! PLAN EXAMINATION AND
BUILDING PERMIT
z
IMPORTANT - Applicant to complete all items in sections: 1, 11, 111, IV, and IX. C)
- -_
ZONIN
f
I• AT (LOCATION DISTRI
LOCATION (NO') (STREET) rJ I
OF BETWEEN--- (CROSS S� ,r: � AND
-R ET) (CROSS STREET)
BUILDING
LOT
SUBDIVISION LOT BLOCK SIZE
fI1
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
2 Addition(It residential, enter number 12® One family 18 ❑ Amusement, recreational
of new housing units added, if any, 13 ❑ Two or more family - Enter 19 ❑ Church, other religious
in Part D, 13) number of units- - 20 ❑ Industrial
3 ❑ Alteration (See 2 above) 14 Transient hotel, motel,
❑ 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory - Enter number
5 F-1 Wrecking (If multifamily residential, m
of units ------- - -- 22 ❑ Service station, repair garage
enter number of units in building in 15 Z Garage 23 ❑ Hospital, institutional
Part D, 13) 16 ❑ Carport 24❑ Office, bank, professional
6 ❑ Moving (relocation) 25 ❑ Public utility
17 ❑ Other - Specify
7 ❑ Foundation only 26 ❑ 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................ j2 7 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 $ v
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
48. Number of stories............
30❑ Masonry (wall bearing) 40 Public or private company 'e C
41 ❑ Private (septic tank, etc. 49. Total square feet n floor ores,
31 "� Wood frame ( p ) all floors, based on exterior
32 ❑ Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 F-1 Other - Specify
42 Public or private company 50. Total land ores, 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�e central air 52. Outdoors........................
36 ❑ Oil conditioninb?
11 L. RESIDENTIAL BUILDINGS ONLY
37 K Electricity 44 ❑ Yes �45 o 5 3. Number of bedrooms..............
38 ❑ Coal
39❑ Other - Specify Will there be an elevator? Full..........
54. Number of
46❑ Yes 47 ❑ No bathrooms Partial........
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Sir
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I hereby certify that the
proposed work is authorized by the owner of record • ,
and I have been authorized by the owner to make this application as has
authorized agent. 4
SIGNATURE OF AGENT`
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY _ TITLE
DATE lg _
Z D�G�/ 7rPl .0 PY
DEPARVENT OF BUILDING INSPECTIONS BUILDING
212 MAIN STREET PERMIT VALIDATION
NORTHAMPTON, MA. 01060
17A - 278
DATE April 27, 19 7_ PERMIT NO. 160
APPLICANT George Lehan ADDRESS 55 Oak St. Florence
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO NAWj�r$&B (1 _) STORY f3 P_t9[!�ip(�&p'ar+E1�E+ DWELLING UNITS
(TYRE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) 55 Oak DISTRICT URB
(NO.) (STREET) .
rn BETWEEN Birdwell AND Bridge Rd
P
(CROSS STREET) (CROSS STREET)
n LOT
m SUBDIVISION LOT BLOCK SIZE
a
p BUILDING IS TO BE 20 FT, WIDE BY 22 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
GI
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
� (TYPE)
u- REMARKS: _ Construct 12 car detached garage
AREA OR PERMIT
VOLUME _ 44r) ESTIMATED COST $ _P7 FEE
(CUBIC/SQUARE FEET)
OWNER GRnrgp-- T_-ban BUIL PT.
ADDRESS 55 Oak Street, Korence, Ma. BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)