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DISTRICT
•
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
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NOTES and Data — (For department use)
C( 7U/7 j/
/1
H
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code r Tel. No.
61014A-AI 1 J� J /7 / & ci -Lk C74 Vo-STS1
01'w ner or !
L )'c�ZFmnl . , t1--e-e c45 f'I A-S e/c-3 1 Builder's
2. /./77' /I� ii.' � IL- 4.---176 License N
o.
: tct0ri.
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.
Sign t re of applicant Address Application date
0)/7
/� I:// DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re wired 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
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 J (5. FOR DEPARTMENT USE ONLY
Permit number
Building `lr , ,/ Use Group
Permit issued L � ``�� ` - 19_ i
Building Q. - ,..� . I Fire Grading
$Permit Fee �( ./ C.
Live Loading
Certificate of Occupancy $ Occupancy Load
Appro ed' by.
r
Drain Tile $ �� / e2 /
Plan Review Fee $ /!!
TITLE
i� ,` CITY OF NORTHAMPTON
MASSACHUSETTS
A., �, )rht
�,�,;, �(� OFFICE of the INSPECTOR of BUILDINGS
Page / l i Plot 07 APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, II, Ill, IV, and IX. O
a t ZONING 1,62_4_
_
I• AT (LOCATION) t i "'�C✓1 t►7\ -/ t DISTRIC
LOCATION (NO.) (STREET) �} (�\j
OF BETWEEN t .c -Q C V� AND ��.C IA c(1., Si-
BUILDING BUILDING (CROSS STREET) (CROSS STREET)
OT 1_ ,{/,.
SUBDIVISION LOT BLOCK L
SIZE i3, 4)-1.2 L. } i
VI
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D -i
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
M
1 I I New building Residenti I Nonresidential
2I I Addition(If residential, enter number 12 IL.I.40ne family 18 I I Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 L _I Two or more family - Enter 19 Li! Church, other religious
number of units- - - - -3. 20 l__I Industrial
3 /—jif teration (See 2 above)
14 I Transient hotel, motel, 21 Ll P• arking garage
4 R air, replacement or dormitory - Enter number
5 Wrecking (If multifamily residential, of units - -3.- 22 r---] Service station, repair garage
enter number of units in building in 15 Ell Garage 23 Lj Hospital, institutional
Part D, 13)
16 L1 C• arport 24 L-ii O• ffice, bank, professional
6 I I Moving (relocation)
17 El O• ther - Specify 25 Li Public utility
7I. 1 Foundation only
26 I_--1 S• chool, library, other educational
B. OWNERSHIP 27 L] Stores, mercantile
8 I rivate (individual, corporation, 28 L_I Tanks, towers
nonprofit institution, etc.) 29 L_i Other - Specify
9 1 I Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential - Describe in detail proposed use of buildings, e.g., food
l/�i r(-)---' processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement $ aZi 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 /10a
b. Plumbing
c. Heating, air conditioning
d. Other (elevator, etc.) ��'�
11. TOTAL COST OF IMPROVEMENT $ ;�"t, t L?V 1
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 I I Masonry (wall bearing) 40 L, Public or private company
31 L__ii Wood frame 41 I_ J Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 I 1 Structural steel dimensions
33 I I Reinforced concrete H. TYPE OF WATER SUPPLY
34 1 1 Other - Specify 42 HI Public or private company 50. Total land area, sq. Ft.—
43 I-I Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 I I Gas Will there be central air 52. Outdoors
36 I I Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 El Electricity 44 Y 45 �'
No
C� es 53. Number of bedrooms
38 I_J Coal
39 I 1 Other - Specify Will there be an elevator" Full
54. Number of
46 I 1 Yes 47 ''�� No bathrooms
Partial