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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — \'umber, street, city, and State ZIP code Tel. No.
w h LL 14�,) e,14 at� 3g� �y�� S6
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.
Sign re of applicant Address Application date
r
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Rev y iew Date Plans B Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL is
OTHER Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Dae
Permit or Approval Check Obtai ed Number By Permit or Approval Check Obtta 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 it ! 7 FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued 19
Building Fire Grading
Permit Fee
$ lt�—�--� � Live Loading
Certificate of Occupancy $ oc poncy Load
Appro by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
3 a OFFICE of the INSPECTOR of BUILDINGS
Page S:)!l Plot K-Ar APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT Q—�LApplica�nnt to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING
I• AT (LOCATION)
I (✓I t 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(It residential, enter number
� 12 One family 18❑ Amusement, recreational
of new housing units added, if any, 13 ❑ Two or more family - Enter 19 �❑ Church, other religious
in Part D, 13) number o units- - - - -�
f 20❑ Industrial
3 ❑ Alteration (See 2 above)
14 ❑ Transient hotel, tel 21 ❑ Parkin
4❑ Repair, replacement g garage
or dormitory — Enter number
5 ❑ Wrecking (If multifamily residential, of units ——————— — i 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 - Speci/y ^�-T C)M 25❑ Public utility
7 ❑ Foundation only
26❑ School, library, other educational
B. OWN RSHIP 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
/4 �(} processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement•,•„•••••...... `�1 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 Is
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..............
49
31 Wood frame 41 ❑ Private (septic tank, etc.) . Total square feet floor ores,
all floors, based on exterior
32 ❑ Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY x 1
34 ❑ Other — Specify 42 ❑ Public or private company 50. Total land ores, sq. ft. ........... J
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 44 ❑ Yes 45 No 53. Number of bedrooms..............
38 ❑ Coal p�J
39 ❑ Other — Spec i/y t' " Will there be an elevator? Full..........
—" 54. Number of
�— T No bathrooms
46 � Yes 47 ' Partial........
�•`D+EPT. OF BUILDING INSPECTIONS BUILDING ZO ` J
+ ! " 212 Main Street 0 a `
Northampton, MA 01060 PERMIT
29 -� VALIDATION
JulyXBX 27, 88 479
DATE t9 7p� ItryranP�RCIIJ No Owner
APPLICANT William Chan ADDRESS
(NO.) (STREET) (CONTR'S LICENSE)OF
New Building torage Shed NUMBERNG UNITS
PERMIT TO g 1_I STORY
(TYPE Of IMPROVEMENT) NO. (PROPOSED USE)
URA
385 Ryan Road, Florence ZONING
AT (LOCATION) DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE 8 FT. WIDE BY 12 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: permit for the construction of a storage shed
AREA
OLUME 96 sg. ft. ESTIMATED COST $ 958.00 — ER 10.00
(CUBIC/SQUARE FEET)
OWNER Same as Applicant BUILD o Il f�
ADDRESS
Same as Applicant's BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pM P