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IDENTIFICATION — To be completed by all applicants Name Mailing address — Vurnber, street, city, a77d State ZIP code Tel. No. Owner or t 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 Address Application date 00 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Required Check Plan Review Date Plans B Date Plans B Notes 9 Fee Started y Approved y BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL $ OTHER Is VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Date Date Permit or Approval Check Obtained 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 �7 7 Bul Iding 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 6 OFFICE of the INSPECTOR of BUILDINGS Pages Plot '7 APPLICATION FOR ZONING PERMIT AND INSPECTOR BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O ����//.+•� .l /1_Y ZONING I• AT (LOCATION) •� Lvv /V � DISTRICT LOCATION (NO.) cSTREET) 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(If residential, enter number 12❑ One family 18 ❑ Amusement, recreational of new housing units added, if any, in -art 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 ❑ 6 ❑ Moving (relocation) Carport 24 ❑ Office, bank, professional 7 ❑ Foundation only 17 ©-Other — Specify 25 ❑ Public utility 26 ❑ School, library, other educational r B. OWNERS �7L 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. 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 1$ O 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....9..... 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 'A 34 ❑ Other — Specify 42 ��y\p' u J blic or private company 50. Total land area, sq. ft. ........... 43 I 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 ❑ O conditioning? L. RESIDENTIAL BUILDINGS ONLY 37 Cj Electricity 44 Yes 45I No ❑ J��- 53. Number of bedrooms.............. 38 ❑ Coal 39 ❑ Other — Specify Will there be an elevator? Full.......... 54. Number of 46 C Yes 47 No bathrooms Partial....... ....,..._.._..,—+z ra.-.ss�.+ -yv..�.!+f'TSrs K+.�e.::a.n'�4w.�anaerz.�m.^;mn..�aw--.ztvr�iro� +q. F:4!, x �. '°4-�'�"!T a �. r i �� �' f r BUILDING WWRAxrm 01060 D PERMIT Qa � Im - 16 VALJDAT10N DATE llfi a: 266 19 PERMIT NO. APPLICANT aiduald W ADDRESS .1 Uywrfw!lk laoid (NO.) (STREET) (CONTR'S LICENSE) NUMBER OF PERMIT TO TORY �. r DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PR OSED USE) AT (LOCATION) 3 D ZONING CT (NO.) ( BEET) BETWEEN (CROSS STREET) (CROSS STREET) LOT SUBDIVISIG1 --LOT BL SIZE BUILDING IS TO BE FT. WIDE BY FT. G B FT-. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION I TO TYPE USE GROUP B MENT WALLS OR FOUNDATION S (TYPE REMARKS? for living quarters, AREA OR PERMIT VOLUME ESTIMATED COST .$ I FEE (CUBIC/SQUARE FEET) OWNER ` s*X4 CO , a B D DEP ADDRESS E WHITE - FILE COPY GREEN - FIELDCOPY CANARY APPLICAN PINK - ASSESSORS COPY M 212 MAIN STREETBUILDING INSPECTIONS BUILDING o •-- - NTttAMPTON, MA. 01060 PERM IT a 25RD - 76 VALIDATION J DATE August 26. 19 81 PERMIT NO. 497 APPLICANT Richard W Ingersnll ADDRESS 3 Riverbank Read _ (NO.) (STREET) (CONTR'S LICENSE) NUMBER OF PERMIT TO Al teratinn (_2_l STORY DWELLING UNITS 1 (TYPE OF IMPROVEMENT) NO. (PRO OSED USE) AT (LOCATION) 3 Riverbank Road — ZONING T SC (NO.) (STREET) 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 2 USE GROUP_ R1 BASEMENT WALLS OR FOUNDATION 1 (TYPE) REMARKS: Tnatal l sad nat4r% dnnr in accessory building R»i ldin9 cannot be used for living quarters. AREA OR ESTIMATED COST $ 200-00 FEEMIT $ 10_00 VOLUME (CUBIC/SQUARE FEET) OWNER BU DI DEPT 00 ADDRESS Z U nrba k Rd,NorthamptAn�• n— B WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT PINK - ASSESSORS COPY