17D-061 (4) ZONING •
FRONT DISTRICT
REAR YARD
IX. SITE OR PLOT
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NOTES and Data — (For department use)
14,009 #A1 _ 6ADY _ i Al 6r- 6
( IW tC f
r
I+ND A�1�Ro'vsA
t
,f"
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, anr( State ZIP code TAI No.�
Owner or
Lessee TI00044�6d— //
C Builder's
t.
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 applic t Address Application date
. ..... Ll i
NOT WRITE IB ELOW 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 Permit or Approval Check Obtta ned Number By Permit or Approval Check Obttaitned 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
II. VALIDATION
Building 9� FOR DEPARTMENT USE ONLY
Permit number
Bul Iding- Use Group
Permit issued 19E,�2
Building Fire Grading
Permit Fee $ de", Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
;off o CITY OF NORTHAMPTON
9` 4 MASSACHUSETTS
r ;
It 0
OFFICE of the INSPECTOR of BUILDINGS
Page _ Plot 61 APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O
,mil^ ZONING //���}}�
AT (LOCATION) �'��r P `��` DISTRICTC "k8
LOCATION "a ) (STREET) }�7
OF BETWEEN _,/ Q/,J�L/ ile , AND S, C.tJ AV
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vr
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D -i
X
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 Lt One family 18 ❑ Amusement, recreational
of neta housing 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
5 ❑ Wrecking (I/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 ❑ Office, bank, professional
6 �� Moving (relocation)
7 ❑ Foundation only 17X Other - Specify 6/ 25 ❑ Public utility
�q! / 26 L❑ School, library, other educational
B. OWNERSHIP ^t J - -2LfLCYifpA. 27 ❑ Stores, mercantile
8 �rivate (individual, corporation, '
28 ❑ Tanks, towers
nonprofit institution, etc.) 67 � =*
? 29 ❑ 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.......................
b. Plumbing .......................
c. Heating, air conditioning.......
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT Is 6� .(�
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 Q'"public or private company
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 L Other - .Specify _ 42 ❑� 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 .......................
35 ❑ Gas Will there be central air 52. Outdoors........................
36 Oil conditioning?
_ L. RESIDENTIAL BUILDINGS ONLY
37 1 Electricity 44 'L Yes 45 1/ No 53. Number of bedrooms.............
38 Coal
39 Other - SpecifyW&pfl _ Will there be an elevators Full.......... /
_ _,�y 54. Number of
46 C I Yes 47 r, J No bathrooms
Partial.......
INSPECTION RECORD
DATE NOTE PROGRESS - CRITICISMS AND REMARKS INSPECTOR
Department of Building Inspections FIELD COPY
212 Main Street
Itrth"ton, Ma. 01060 BUILDING
t
17D - 61 PERMIT
_t DATE November 19, 19 so PERMIT NO. 690
APPLICANT Michael Jacobson-Hardy ADDRESS 21 Garfield St., Florence-
(N 0.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Wood stove ( 2 ) STORY wood-stOVe installation DWELLING UNITS 2
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE) f�7�
ZONING
AT (LOCATION)
'21 Ga d DIISTR CT yRA
(NO.) ET),....\
f" \\
rn BETWEEN Garfield Ave, AND Straw Ave.
�o (CROSS STREET) (CROSS STREET)
rn
LOT
(L SUBDIVISION LOT "` BLOCK SIZE
m
O BUILDING IS TO BE FT. WIDE: BY T. kNB FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O m
O Z TO TYPE USE GROUP EMENT WALLS OR FOUNDATION
� (TYPE)
0 REMARKS: TimstAll.. vacdl burnfust ay in x1st'�1Et chimney an first floor
AREA OR ESTIMATED COST $ 100_00 FEEMIT
VOLUME
(CUBIC/SQUARE FEET)
OWNER Michael & Ruth Jacobson-Hardy
I;'k,
ADDRESS 21 Garfield Street, Florence, Ma, 01060 BY