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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
1.
Owner 2-2-- G)L t-Z /
Lessee -� ✓�
Builder's O
2. 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.
Si ature � Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number By Permit or Approval Check Date Number B
Obtained Obtained 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 A, ^7 FOR DEPARTMENT USE ONLY
Permit number [1
Building. Use Group
Permit issued - )Vtf�, 19 �
Building Fire Grading
Permit Fee $ _����
Live Loading
Certificate of Occupancy $ Occupancy Load
Ad by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete a// items in sections: 1, 11, 111, IV, and IX. 0
�t'`f` I 'V ZONING
I AT (LOCATION) )1- 2— T E 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 El Upw building Reside ial Nonresidential
2 Addition(If residential, enter number 12 e family 18 ❑ Amusement, recreational
of new 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 l
t
l
t
h
i
Transent hotel, morel,❑ 21 n Parking garage
4 F__] Repair, replacement or dormitory — Enter number
5 ❑ 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 E:] Moving (relocation)
7 ❑ Foundation only 17 ❑ Other — Specify 25❑ Public utility
26 ❑ School, library, other educational
B. O7Private fil P 27�� Stores, mercantile
B (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
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,,,,,,,,,,,,,, Q U 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 1$
III. SELECTED CHARACTERISTICS OF BUILDING —JFor 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 I
30❑ Masonry (wall bearing) 40 [P Public or private company 48• Number of stories................
31 F 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 E:] 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 1. TYPE OF MECHANICAL 51. Enclosed ......................
35 L1—d/Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning?
_� L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 ❑ Yes 45 7&`, N/o 53. Number of bedrooms..............
38 ❑ Coal
39 Other — Specify Will ?here be an elevator? Full..........
54. Number of
46 L—] Yes 47 TO No bathrooms
Partial.......
i e
DEPT. Oitilboll INSPECTIONS BUIEG �o
212 Main Street 0< $40.00
Northampton, MA 01060 PERMIT
29 - 165 p VALIDATION
DATE May 2, 19 85 PERMIT NO. 223
APPLICANT Morris Cave ADDRESS 22 Gi 1 ral n TPrY_ _ Clc.Tncr
IND.) (STREET) ( S LICENSE,
PERMIT TO Addition I_) STORY Family Room - WELLING OF
UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 22 Gilrnin TPrY_ ZONING URA
DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
ADDITIIOONN L1IS TO BE FT. WIDE BY 20 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: permit for the addition of a family room
P
VOLUME ER MIT
AREA OR 320 sq. ft. ESTIMATED COST $ FEE
(CUBIC/SQUARE FEET)
OWNER Same as Applicant D �,P Ja
ADDRESS Same as AWl i Cant'S
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pJN p