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.D
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REAR YARD
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NOTES and Data — (For department use)
Aw
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
A
1.
Owner or IR
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.
Sig lure of appli nt Address Application date
cl
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
Date Permit or Approva I Check Obtained Number By Permit or Approval Check 0btta tned 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 j� FOR DEPARTMENT USE ONLY
Permit number L�
Bui lding Use Group
Permit issued (; 19 _
Building Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
V
Page *� Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O
ING
(• AT (LOCATION) A41VI, � _ DIOSTRICTC)R,
LOCATION ("°•' (5T E
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
H
II. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D —�
X
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
M
1 New building Resid tial Nonresidential
2 n Addition(If residential, enter number 12ZOne family 18 Amusement, recreational
of new housing units added, if any,
in Part 1), 13) 130 Two or more fomily - 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 C� 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) '
17X Other - Specify 25 n Public utility
7 Foundation only 26 L� School, library, other educational
B. OWNERSHIP tJY��t t �- 27 Stores, mercantile
��,J{ 26 Tanks, towers
B Private (individual, corporation, �[
nonprofit institution, etc.) 1� eL7�r 29 n Other - Specify
9 D Public (Federal, State, or
local government) 'fit✓
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.)............. qq^^
11. TOTAL COST OF IMPROVEMENT I$p((sfjj.GJ
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
30onry (wall bearing) 40 Public or private company 48. Number of stories..............
31 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
34F] 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 I. TYPE OF MECHANICAL 51. Enclosed .......................
35 LJ Gas Will there be central air 52. Outdoors........................
36 Oil conditioning?
_ _ L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 77 Yes 45 ' No
_ � _J _-. 53. Number of bedrooms..............
38 Coal
39 Other - Specify Will there be an elevator? Full..........
54. Number of
46 [_� Yes 47 I No bathrooms
Partial.......
hereby certify that the proposed work is authorized by the owner of recad %rf
and I have been authorized by the owner to make this application as his
authorized agent.
SIGNATURE OF AG9NT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE l9
DEPARTMENT OF BUILDING INSPECTIONS z D
DEPT. FILE COPY
312 MAIN sTlt>>�T ¢ ►/a d a d_g/
NORTHAMPTON,, MA* 01060 BUILDING �a
35 - 186 PERMIT VALIDATION
DATE Fa'6ruA * is Al PERMIT NO. 47
APPLICANT $d*d.tL bl-tt -ko ADDRESS 1397 llyat d-
(N0.) (STRREET) (CONTR'S LICENSE)
PERMIT TO (_,1_,) STORY NUMBER OF
YPE OF IMPROVEMENT) NO. W���bu(('RR.PO 08us�E a DWELLING UNITS l
AT (LOCATION) 1397 $.VA[� AnAd ZONING
DISTRICT
(NO.) STREET)
0 BETWEEN AND
ro (CROSS STREET) (CROSS STREET)
B. LOT
m SUBDIVISION LOT BLOCK SIZE
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
I
Ir (TYPE)
LL REMARKS: Comat3nict exterior mannuary c-himnay and install wood+bnrniIIst Stare
in b� 8�1II.
AREA OR PERMIT
VOLUME ESTIMATED COST
Rf1A FEE l ��Q
(CUBIC/SQUARE FEET)
OWNER — Ittiwiu Matumtka
ADDRESS 1397 an $d la Nnr =tnn_ Ma 01060 BUI LNG EPT,
(Affidavit on reverse side of application to be completed by aut gent of owner)
>i
INSPECTION RECORD
DATE NOTE PROGRESS - CRITICISMS AND REMARKS INSPECTOR
FIELD COPY
ItTPART]! '
OF WILDING INSPECTINS
212 MAIN STRUT
. 41060 BUILDING
35 - 186
PERMIT
DATE Robyiar_j' 19 Ill PERMIT NO. 169
APPLICANT s-k- ADDRESS
(N0.) (STREET) (CONTR'S LICENSE)
PERMIT TO (�) STORY NUMBER OF DWELLING UNITS
1 EMENT) NO. PROPO D USE
ZONING
AT (LOCATION) DISTRICT SR
(N0.) (STREET) �
(
rn BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
m SUBDIVISION LOT BLOCK SIZE
U BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O I
m
o d
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
E
O: (TYPE) f
O
LL REMARKS:
is
AREA OR PERMIT
VOLUME ESTIMATED COST $ W.00 FEE _
(CUBIC/SQUARE FEET)
j
OWNER � 1�ifiti�t4� BUI ING PT. j
ADDRESS -13597 Ryan 11d v NOTthamptanp MA- 0'1060 BY