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NOTES and Data (For department use)
L
IV, IDENTIFICATION — To be completed by all applicants
Name Mailing address - Number, street, city, and State ZIP-code Tel. No.
1. � � • �,% ,_ � � --f_."+jr' t �L. � �' i �'
Owner or
Lessee
s
y� Builder's
1. ^j.�_/;.� f ivL<- c License No.
Contractor G f
-.• :/,r
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 Address Application date
DO, 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 s
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date ate
Permit or Approval Check Obtai ed 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 �C( ✓ FOR DEPARTMENT USE ONLY
Permit number
Building. Use Group
Permit issued _ 19 "2Z
Building Fire Grading
!' '
Permit Fee $ �.
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile
Plan Review Fee
tTLE--
CITY OF NORTHAMPTON
+ MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page Plot /_' APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
GJ `� I ZONING (7
• AT (LOCATION) „ -t f J - � C `= L/ '1��- �(- �.7 "7 DISTRICT. /\ j
LOCATION (N0.) (ST REE )
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vr
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
2L Addition(If residential, enter number 12t❑� One family 18 r❑ 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 ❑ 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)
7 ❑ Foundation only 17 Other - Sped/y 25 ❑ Public utility
26 ❑ School, library, other educational
B. ERSHIP 27 �❑ Stores, mercantile
o�N 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,•,,,,,,,.,•..•. �. / l�G` 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..................... `I
b. Plumbing .....................
c. Heating, air conditioning.......... t
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT 1$
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 f?
30 Masonry (wall bearing) Public or private company 48. Number of stories.....�.......
49. Total square feet of floor area,
31 Wood frame 41) Private (septic tank, etc.) all floors, based an exferi r
32 ❑ tructural steel dimensions .. /�. ...... / -
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other - Specify 42i_XPublic 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..............
36 Oil conditioning?
L. RESIDENTIAL BUILDINGS 0 �LY
37, Electricity 44 Yes 4 �l No 53. Number of bedrooms/,- � � .
38 ❑1 Coal ,1^
39 ❑ Other - Specify Will there be an elevator? Full.
54. Number of l�/�
46 [❑ Yes 47, No bathrooms
Partial.....
Department of T3uildin; Inspections BUILDING o°
212 Tsain Street
Northanipton, 'Vass. @1069 EItI�11T IIa.P as
PERMIT
35 - 213 VALIDATION
DATE June 21, 19 83 PERMIT N0. 2q5
APPLICANT i".'arren Jones Jr. ADDRESS 24 Titrlce=�� Wi 1 Ryan n4�L,71
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
Addition (_) STORY 0n �+?''i�V DWELLING UNITS
-- PERMIT TO -
(TYPE OF IMPROVEMENT) N0. (PROPOS D USE)
ZONING q�
AT (LOCATION) 2G Turkey Hill toad - DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE 1:> FT. WIDE BY 16 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: der-,At to add a bet) roor, on the s000nd floor and a dining foornm nn the fi -st floor
AREA OR $ 7,250,Q0 FEEMIT
ESTIMATED COS ? ,{1L
VOLUME T
(CUBIC/SQUARE FEET)
Barren Jones Jr.
OWNER BUILD G PT.
ur 7r 1. boa. BY
ADDRESS
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT C , PINK - ASSESSORS COPY