32A-138 (23) DEPT. RLE cony
BUILDING
PERMIT
VALIDATION
DATE A{ass+ `22 14 77 PERMIT NO. ,y:9
APPLICANT Ralph Parcia ADDRESS Rq v.EZMEE. strati.
(ft oTREET) ICONTR'% LICENSE)
NUMBER OF
PERMIT TO RennVatinn_Raaidanna (X I STORY Rat/Sante DWELLING UNITS I
(TYRE Or IMPROVEMENT) 0. (PROPOSED USE)
ZONING
AT(LOCATION) _.._.7K]fain S}^wt- _. — DISTRICT a
(Nd) IETREETI
e. BETWEEN_ AND _
(CROS% STFEEO (CROSS STREET)
LOT
a▪ SUBDIVISION LOT BLOCK SIZE
p BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
ena
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
5 (TYPE)
cc
a
N REMARKS: Ranouwi tjo a Peas eterg aAROR
Q. �1�^JEMIT
VOLU $ME ESTIMATED COST r000 FE
$
�.p (tGNOO
(CU inns+ E TEST) �'/ er'`�/
OWNER Joshua's Inc. 401,
ADDRESS 23 Main S}Tnae} B �l AP
(Affidavit on reverse side of application to be completed by authorized agent of owner)
I hereby certify that the proposed work is authorized by the owner of record
and f have been authorized by the owner to make this application as his
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19_.
�, Tidily of Northampton /]
..).-.1,4...:8":-
(ke.
l $dassntlplsetis 5/
r_.�.� "/
�� > Tidily
of the �Insperton nEuilDings 9t,
APPLICATION FOR
� Plot J--;ie ZONING PERMIT AND
Page_.7.
ABUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections:- I, II, III, IV, and IX. p
I. AT (LOCATION) 02 MA i N S7 RE Lt DISTRlcT( r./3
LOCATION (Na.) (STa"TI SC-
BF BETWEEN AND
BUILDING 'r°°:' "°EeTI (CROSS STREET)
LOT
$VBOIV IS ION LOT BLOCK SIZE
CO
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D 53
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
-I
M
1 I I New building Residential Nonresidential
2 lei Addition(If residential, enter number 12,2iOne family 18I I Amusement, recreational
of new housing units added, if any.
in Part D. 13) 13 Two or more family - Fater
- 19 Church, other religious •
� �_
3A Alteration (See 2 above) number o/ units-- - - y 20I I Industrial \'�
14 I I Transient hotel, morel, 21 1 1 Parking garage a1
4 El Repair, replacement or dormitory - Enter number
5I I Wrecking (If multiform ly residential. of units y 221 I Service station, repair garage
enter number of units in building in 15 I I Garage 23 ❑ Hospital, institutional
Part D, 13)
16 I Carport24❑ Office, bank, professional
6 I I Moving (relocation)
Foundation only 17 L I Other - Specify 25❑ Public utility
26 School, library, other educational 1 •
B. OWNERSHIP 27I I Stores, mercantile t
8N Private (individual, orpor on, 2B 1 1 Tanks, Owers
a
nonprofit Institution etc.) 29 ❑ Other Specify ^/T
9 ❑ Public (Federal, Stare, of J 1
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 b IS/:,r school, secondary school, college, parochial school, parking garage for,
deportmentental office building, office building atindustrial plant.
To be iv Called but not included If use of xisting building is being changed, enter propoed use.
in the above cost
a. El tr' al
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. D
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS [[ rn
30�Ma Dory (wall bearing) 40 Public o private companyasNumber of stories "1 m
31 IXWood frame 41 `-J Private(septic tank, etc.) 49' Total floors,sqsbae feet of floora
t all based onexteriore /� 5
32 X Structural steel _ - dimensions h .l i51//J j
33 Reinforced concrete H. TYPE OF WATER SUPPLY
34 L J Other - Specify 42,12kPublic or private company 50. Tocol land area. sq. ft
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
9
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed t-
en
35 1 I Gas Will there be central air 52. Outdoors (.2-...(.2-... -1
36 Oil conditioning' L. RESIDENTIAL BUILDINGS ONLY
37 El Electricity 441 I Yes 45 X.No 53. Number of bedroomye2- IJ
II`yy
38 El Coal / .l
39 Other- Specify Will there be an elevator? 1 Full
54. Number of (`1
46 ql Yes 47I I No bathrooms
f P vol
IV. IDENTIFICATION — To be completed by aft applicants
Name Mal ling address – � .�, .rt . . ten, ZIP code TeL No
r r u.d
S
G_neror ��sh rs /nit_ T—
Les ee
k.
.1-1/1
&
Contractor /r
A.chrec, ark f.'. �� - -. ._ ; ' .tat–+'r• /L.C.l�C-V
Gegineer
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.
Signatureapplicant of applicant Address Application date
'Pajf/4. ?t wAH fv S G.. ,.s,11 1
DO NOT WRITE BELOW THIS LINE
V, PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date PlansDateDate Plans ByNotes
quireFee Started By A pproved
BUILDING S
PLUMBING S
MECHANICAL
ELECTRICAL S
OTHER ._ S
VIL, ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
e
Pern,rt ar Approval Check Obtained Number By Retell o, Appravoi Check Obtained Number By
tat
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 ...........
Permit number 6
Building
Permit issued 19
Building
Permit Fee $
Certificate of Occupancy $
Approved by:
Drain Tile $ __
Plan Review Fee
TITLE
NOTES and Data — (Far department use)
VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT ......
USE
FRONT YARD ...
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use :w:7;�aaZ '
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