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IDENTIFICATION — To be completed by all applicants Name Mailing address — Number, street, city, and State ZIP code Tel. No. Owner or ' Lessee 4 t a gas-m 0733 i N s SSG cT 76/ Builder's 2 License No. Contractor 1 C 3. l ___.__..._. 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 llys authorized agent and we agree to conform to all applicable laws of this jurisdiction. Signaturef a9p cant j' Address �S� Lp�/JySGif��cs/! ���' Application date �'7���""mot", �__ ����.i'�'C'!L'L� /r°'fJy//�7'y/�1�1✓� f�� Q���U 00 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Re wired Check Plan Review Date Plans By Date Plans By Notes 9 Fee Started Approved BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL $ OTHER $ V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS te Date Permit or Approval Check ObtaaTned Number By Permit or Approval Check obtained 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 FOR DEPARTMENT USE ONLY Permit number Building /1� <70 Use Group Permit issued 19 Fire Grading Building Permit Fee $ © 'DC� Live Loading Certificate of Occupancy $ Occupancy Load Approved by: j Drain Tile $ Plan Review Fee $ 9 A TITLE CITY OF NORTHAMPTON B MASSACHUSETTS r OFFICE of the,.�NSPECTOR of BUILDINGS Page P10t r) APPLICATION FOR ZONING PERMIT AND INSPECTOR BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O I• AT (LOCATION) ZONING DISTR CT LOCATION (N0.) (STREET) OF BETWEEN AND BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT 1_BLOCK SIZE H II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D —+ A. TYPE IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use rn rn 1 e vrbuild«n SGc'�Afl- Y& Residential � g P6'ci- 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 l t l t t h i Transenoe , motel,❑ 21 L_� Parking garage 4 ❑ Repair, replacement or dormitory — tinter number 5 ❑ Wrecking (II multifamily residential, of units ——————— — -- 22 Service station, repair garage enter number of units in building in 15 ❑❑ Garage 23 Hospital, institutional Part D, 13) 6 Moving (relocation) 16 L] arport 24 7 Office, bank, professional 7 Foundation only 17 C'J tether — SpeciJy 25 I Public utility 26 C� School, library, other educational B. OWNERSHIP S6C/ �l7/OGrL 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 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. 7'o 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 _scree 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................ 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 34 ❑ 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 ❑ Gas Will there be central air 52. Outdoors........................ 36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37 ❑ Electricity 44 ❑ Yes 45 1 ,1 No 53. Number of bedrooms.............. 38 ❑ Coal `- 39 ❑ Other — Specify WiII there be an elevator? Full.......... 54. Number of 46 l r Yes 47 ❑ No bathrooms Partial........ DEOT. OF BUILDING INSPECTIONS BUILDING Z 212 Main Street CA Northampton, MA 01060 PERMIT 4a 35 - 226 VALIDATION DATE April 11 , 19 RA PERMIT NO. 226 APPLICANT 21&4c"" 54 1 ari /s4l n P1^ 1 n_ Owners (NO.) lSTRARp (CONTR'S LICENSE) NUMBER OF PERMIT TO STORY QA@ P P DWELLING UNITS (TYPE 1 T) NO. ( OSE USE) ZONING SR AT (LOCATION) DISTRICT (NO.) E BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: permit for the installation of an in-ground pool to be surrounded by a 4' fence with a self locking gate AREA VOLUME 18 X 36 = 648 sa. ft. ESTIMATED COST .$ 5,200.00 FEE MIT .� 10.00 ICUSIC/SQUARE FEET) OWNER Same as Applicants BUILD Same ' ADDRESS .__...� as Applicants'icants BY 41Z�� WHITE - FILE COPY . GREEN - FIELD COPY • CANARY ^ APPLICANT COPY • PINK ^ ASSESSORS COPY pINT IIP