32C-145 ZONING •
DISTRICT
SIDE r SIDE YARD
REAR YARD
NOTES
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OR PLOT
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NOTES and Data — (For department use)
r
Y
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or
Lessee f
" Builder's .:
2.
i � 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.
Signatu of a pli nt� Address Application date
�G
Y21Z 42 3
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re wired Check Plan Review Date Plans BY Plans B Notes
q Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL Is
OTHER Is
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Obta ned Number By Permit or Approval Check Obta t ed 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. Use Group
Permit issued
Fire Grading
Building
Permit Fee $ f_ �'l Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee
TI
CITY OF NORTHAMPTON
�• MASSACHUSETTS
e OFFICE of the INSPECTOR of BUILDINGS
.�, Page 2, C_ Plot l6z. � APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING
I• AT (LOCATION) LAC DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
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 12A One family 18 ❑ Amusement, recreational
of new bousing units added, if any,
13 Two or more family — Enter 19 Church, other religious
in Part D, 13) ❑ Y � ❑ 9�
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 F1 Wrecking (If 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)
17 ❑ Other — Specify 25 ❑ Public utility
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
B 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
/� ^a processing plant, machine shop, laundry building of hospital, elementary
10. Cost of improvement•y,�ea�(.I;",,, (,! A school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office building at industrial plant.
To be installed but n:t 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 1$ 0D0i
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❑ Masonry(wall bearing) 40 Public or private company 48• Number of stories................ re
31 gC Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area, � / rn
L4
all floors, based on exterior i
32❑ Structural steel dimensions .....................
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34❑ Other — SpeciJy 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 Electricity 440 Yes 45 X_ No 53. Number of bedrooms..............
38 Coo I
39❑ Other — Spat iJy Will there be an elevator? Full..........
54. Number of
46 � Yes 47 Y I No bathrooms
�_' Y1—' Partial.......
apartment of Building Inspections
.2 Mait: S&e"et BUILDING
)rthamp ton, Ma. 01060 0°
�a
32C - 145 PERMIT
VALIDATION
DATE February 1511. 19 83 PERMIT NO. 68
APPLICANT Patil .T_ Rrirt ADDRESS 204 Main S y HaVdonyill_ 002866
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO Rep r_ n a esidPnli NUMBER OF
_—pZ,s4,ta'-j Q 1 C@ (2_) STORY R al DWELLING UNITS 6 _
(TYPE OF IMP//FOVEMENT) NO. (PROPOSED USE)
AT (LOCATION) ,L Mi r-ho man AV nue ZONING
l B DISTRICT 11Rr
(STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
1EMARKS: Repg4ir vACant A Family house, Instal! now xd mdows, Insulate, sheatzock, zepmir
siding XU4 and porches, mist. alterations & repairs.
REA OR PERMIT
OLUME ESTIMATED COST $ '1() 00n FEE $ 120-00
(CUBIC/SQUARE FEET)
WNER R- Cchnei dexr R. RE+rgornfl/P_ Rri tt BUILD G D T.
DDRESS BY 41L
WHITE - FILE COPY GREEN - FIELD COPY ■ CANARY - APPLICANT COPY • PINK - ASSESSORS COPY