29-202 (3) 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 01969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
I I an
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or
Lessee
Builder's
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.
Signature of applicant :Zd,.�ress Application date
Nlf/ r/
! 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
9 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or A rova I Check Data Number B Permit or Approval I Check Date Number By
PP Obtained y pP 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
BUI lding Use Group
Permit issued c2,5. 19 , 411
Building �7 Fire Grading
Permit Fee $ �•��fA Live Loading
Occupancy Load
Certificate of Occupancy $
Approved by:
Drain Tile $ 1
Plan Review Fee $
E
NOTES and Data — (For department use)
_ - L
L
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 PLAN EXAMINATION AND
u J — BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, III, IV, and IX. O
ZONING J i
• AT (LOCATION) �`. ""� r �r -/ �C ° •-�-^ DISTRICT ,
LOCATION (NO.) (STREET) ��^
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vf
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
-a
1 ❑ New building Residential Nonresidential
2 ❑ Addition(If residential, enter number 12 One 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 ❑ Transient hotel, motel, 21 ❑ Parking garage
4 ❑ 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 ❑ Moving (relocation)
17 ❑ Other - Specify 25❑ Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8 ❑ 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
p� processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement................ �K, 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 /$ .- 4" `
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........
30,71 Masonry (wall bearing) 40 Public or private company
31 W Wood frame 41 ❑ Private (septic tonk, etc.) 49. Total square feet of floor area,
all floors, based on exteri
31tl Structural steel dimensions . .�yiZ7 � b �• -'--
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34❑ Other - Specify 42 jx 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.......................
conditioning?
36 ❑ Oil L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 ❑ Yes 45, No 53. Number of bedrooms..............
3B ❑ Co.1
39❑ Other - Specify Will there be an elevator? Full..........
�y 54. Number of
46 E] Yes 47 1 JQ No bathrooms Partial........
I hereby certify that the- proposed work is authorized by the owner of record
and I 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 1g ,
I t-
t _
Ak DEPT. FILE COPY
DEPART DF BUILDING INSPECTIONS Zo
212 MAIN SMUT
NaRTBAl�7'13N 0 060 , BUILDING
2 9 PERMIT VALIDATION
•• Z�2
DATE `M 259 19 79 PERMIT NO. 226
APPLICANT Joseph SYkier _ ADDRESS 8
_-7—East Hadley Na.
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Alter residence ( 2 ) STORY Cosmetie Charges DWELLING UNITS 1
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 43 Baattl® Drive ZONING
DISTRICT URA
(NO.) (STREET) -
a BETWEEN AND
'D (CROSS STREET) (CROSS STREET)
w
a LOT
m SUBDIVISION _LOT BLOCK SIZE
a
U
0 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
E
� (TYPE)
U- REMARKS: Newnabinets, bow bay Wndaw lam_!), n,-w 36" door- c3osmtic ohar;es
AREA OR VOLUME ESTIMATED COST $ . 2,000 PERMIT
(CUBIC/SQUARE FEET) ' EE $ 10.00
11
OWNER Briggs
ADDRESS X4'3 Beattie Dr. N'ton. BYI 1 D P
(Affidavit on reverse side of application to be completed by authorized agent of owner)