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17A-274 (4) VIII. ZONING PLAN EXAMINERS NOTES DISTRICT USE FRONT YARD SIDE YARD SIDE YARD REAR YARD NOTES IX. SITE OR PLOT PLAN — For Applicant Use 1.- d rt. t4 �� - �* € f � j " �r + d s b4 I I J '� a3 + yax ' F 1 ' Y R is 6 � t m z r �+ + } 'Y F d I xi ,E f f- ( t a + s , 1 p �s �t-a..;�.t. q..a"y�a s G { .x - - l rs r a}�4-1- 1�4 w-+ .4,,H, j4 A 1� -_�� y �<�E�,"a -€ - P�'- s ;... .¢q5f # x .�.�.; 1 -• f' ' ` Y "? 4 Y¢-}.•fi -i -{-... -+s-}-« -,- y,2.a. a. z ;..i.;-.� 1,r 4f}E�. { t H4 L s a k.'a f 4--i,.y`i.T..O�$s +.t j-fi�§ {41; ..q.. a+ z x3 i._{ d;97 Y"?fa ra r 77-414 . .. 1 .'^ 4� bJ 4 a "1-s. -r a z "tA a ?&7 t f rt 4: > o- 4- 'y f �� r t P r + E -§ s� t-p ttt� 9 -r f f�-F 4 f s 4 g + g } �.�. r ,.�y-.:.� r ,i:..b} .i.g.z.-...+ .�. .�d."; +., +-r-s"aI =ter a' ( # F �:" ' S='Fad+�i "' 2 -k 1kd §} t t y �'yd.i-fr ¢y fr i ed k d d d E.'i d d § -3.-- ?- d x.-� " 1 �p I t �-1- " }t $� -r f t -,"P a J-fe,r-z; y .1 t r ;d,�..t. 4 4 1 # a Pt a < t + «o.�- f - BOCA FORM APEBP — 669 C1969 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. 1;--Ie Al YT Owner or Lessee Builder's 2 /?H C AS' 6� � 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 L D0 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 Date 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 Z, Use Group Permit issued 19-1-- Fire Grading Building $ 6.6 Permit Fee 1(� o V Live Loading Occupancy Load Certificate of Occupancy $ A oved by: Drain Tile $ Afshj Plan Review Fee $ TITLE NOTES and Data — (For department 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. 0 L OCATION AT (LOCATION) L ,Q/(/N O') DISTRICT / �J (STREET) OF BETWEEN �di/'l f /tLI` I AND BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE Vf 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(If 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 ❑ Industrial 3 ❑ Alteration (See 2 above) 14 Transient hotel, motel, 21 ❑ Parking garage 4 ❑ Repair, replacement or dormitory — Enter number 22 ❑ Service station, repair garage 5 ❑ Wrecking (If multifamily residential, of units ——————— — --30- enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional Part D, 13) 16 ❑ Carport 24❑ Office, bank, professional 6 ❑ Moving (relocation) 17 Other — Specify S#,eJ-1 25❑ Public utility 7 ❑ Foundation only I `' 26 ❑ School, library, other educational B. OWN E HIP / !y �+ 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 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�onry (wall bearing) 40 ❑ Public or pr votecompany 49• Number u stories...... area, ... 31 Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square Feat n floor area, all floors, based on exterior 32❑ Structural steel dimensions ..................... 33 ❑ Reinforced concrete H. TYPE OF WATER�SUUPPL,I� 34 F-1 Other — Specify 42 ❑ Public or pri{a e c000mppaa'ny 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 37 ❑ Electricity 44 ❑ Yes 45 No 53. Number of bedrooms.............. 38 ❑ Coal i (' ' 39 F-1 Other — SpeciJy /'� Will there be an elevator? 54. Number of 46 ❑ Yes 47 bathrooms Partial........ hereby certify that the proposed work is authorized by the powder of record and I have been authorized by the owner to make this application as his authorized agent. E _ SIGNATURE dF _AGtNT ADDRESS (NUMBER) (STREET) (CITY) APPROVED BY TITLE DATE 19 i, , DEPART MEW OF BUIMINa INSPECTIONS j o DEPT. FILE COPY MAIN aT�� BUILDING�oR TN, ma. ©6o Q a PERMIT VALIDATION 17A - 274 DATE April 2* 19_79 PERMIT NO. 9o_8 APPLICANT Rki ij-n Psidska'k ADDRESS 29 Fern St. Flo. (NO.) (STREET) (CONTR'S LICENSE) OF PERMIT TO Con$truet 'tool shed (--L)) STORY Tool Shed DWELLRING UNITS 1 (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ZONING AT (LOCATION) 2 I%rn St DISTRICT LB (NO.) (STREET) a BETWEEN Oak AND Dead end b (CROSS STREET) (CROSS STREET) a LOT 0. SUBDIVISION LOT BLOCK SIZE m p BUILDING IS TO BE 8 FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION to O Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) O: LL REMARKS: Construct tool shed AREA VOLUME 80 ESTIMATED COST $ 150.00 FEEMIT d 'O.QO (CUBIC/SQUARE FEET) ,P OWNER Edwin Padeek BUIL ADDRESS 29 Fern St. , Flo BY (Affidavit on reverse side of application to be completed by authorized agent of owner)