32A-255 (155) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
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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.
Owner or C7
Lessee
Builder's
F,f 2. N
.
Contractor
3.
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 Applicat,ion to
--XI
00 N O T W R I T E BELOW T H I S L I N E
V. PLAN REVIEW RECORD For office use
Plan Review Date Plans By Date Plans By Notes
Plans Review Required Check Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
V11. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date By Permit or Approval Check o Do te d Number By
Permit or Approval Check Obtained Number Obtained
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 $ Live Loading
Occupancy Load
Certificate of Occupancy $ Approved by:
Drain Tile $
Plan Review Fee
NOTES and Data — (For department use)
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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,E IV, and IX.. 0
I. AT (LOCATION) �1CcC�� _S r/ i DIOSTR CTS--.J- _
( W�/ }�Cp "7�/
LOCATION W 1 jG—��j�.�' cc'uAJTR� s/J� 't
OF BETWEEN 140 r� L f"Ve ����! AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
11. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use 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
of units — -.� 22 ❑ Service station, repair garage
-------
5 ❑ Wrecking (If multifamily residential,
enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional
Part D, 13) 16 24 E] Office, bank, professional
17 Other — SpeciJy Carport
6 ❑ Moving (relocation) 25 E] Public utility
7 ❑ Foundation only f - 26 ❑ School, library, other educational
B. OWNERSHIP f �Ot 27 ❑ Stores, mercantile
8 ❑ Private (individual, corporation, �y J r �y� 28 ❑ Tanks, towers
nonprofit institution, etc.) / LIJZ{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 $3S—Q), �
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
for wrecking, complete only Part J, for all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
48. Number of stories................
30❑ Masonry (wall bearing) 40 ❑ Public or private company
49. Total square feet of floor area,
31 Wood frame 41 ❑ Private (septic tank, etc.) all floors, based on exterior '� i
❑ S6,
32❑ Structural steel dimensions .....................
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 F-1 Other — Specify
42 ❑ Public or private company 50. Total land area, sq. ft. ...........
43 ❑ Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .....................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35❑ Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37❑ Electricity 44 ❑ Yes 45 ❑ No 53. Number of bedrooms..............
38 ❑ Coal
39❑ Other — Specify Will there be an elevator? 54. Number of Full..........
46 ❑ Yes 47 ❑ No bathrooms Partial........
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CERTIFICATE ISSUED
Rim— w
DATE
B' DI G PERMIT -
1
TwIc
AEATE #I" OCCUPANCY
All
DATE -t4 PERMIT NO,;
A4L{6ANT tcONTR's LICENSE)
Aml N ER
,
PERM{T TO °; _ �> _? STdRy OiN LL2TfCi. NITS,
E Tj (PROPOSED USE)
k
AT ('0CAT164) 615TR CT
� 5� � Y r �iF � f✓ >. f 8 .�
a BETSYEEt A14D
{CitQS$ STREET} •_ y,
(CROSS—
m s a LCt'T '
S
a $'I C BLOCK E
p vtc k 16 a E—ter- --FT. WIDE 6Y FT L r� �T. )w r�Ei�+rt 4r4i s-1�A3�#• c c��r Div cot�sr�uct�oN
USE GROUP 8RS@MENT WA{,4 v OR FONDATION
E
3 r,
nil
AFMA k R>rtlPt# s
h4 �y---•a—------�f
\CUBIC/SQUARE FEET)
-- ii}".'H 70 FE7►�".'H tf. R7Y!'NlDr7_'fta• '1';Y - RY
"
OWNER
SE SE R ONtHT 1F
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 4s _
authorized agent.
SIGNATUP't OF 'AbtMT
ADDRESS 1 ,: ::C
r (NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
DEPARWENT OF BUILDING INSPECTIONS DEPT. PILE COPY
ZO
X212 MAIN STEM
rt��xAtnw, mk. 01060 BUILDING .9 0.
� T
PERMI ` VALIDATION
32A - 255
DATE my 9. 197_ PERMIT NO. 312
APPLICANT Pill Ra IE r (118,=Ant= ADDRESS 2 A"11ngt 5 . NI-hon.
(NO.) (STREET) . (CONTR'S LICENSE)
PERMIT TO Al NUMBER OF
ter �'1t18�.nI�BA (�_) STORY �'fe� DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING CB
AT (LOCATION) 36 King Street Wiggins Country Store Inc. Hotel N ton• DISTRICT
(NO.) (STREET)
a BETWEEN - AND
io (CROSS STREET) (CROSS STREET)-
a
LOT
O SUBDIVISION LOT BLOCK SIZE
m
U
O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
[t:
LL REMARKS: Window presently blocked Lm with concrete block and stucco. Installing a
bay window 71 2 f t. by 9 ft.
AREA
OLUME ESTIMATED COST $ 2500.00 __ — FEEMIT 10.00
(CUBIC/SQUARE FEET)
OWNER Ocram, TYf ---- BUI IN EFr
ADDRESS "� tl� �t �st� Nor'bhawton- Mar BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)