23A-115 (6) For ALL buildings within Fire District and for other buildings costing $10,000.00 or more, plans
and specifications must be submitted to the Inspector of Buildings for examination and approval.
If building is to be moved give details relative to proposed location as for a new building.
A13-plication for Permit to Build
s�
Northampton, Mass., 4..1...... I ...... 19-i. :.......
To the Inspector of Buildings:—
The undersigned hereby applies for a permit to build, move, alter, or repair, according to the
following specifications.-
1. Owner's name .......... :............ ........ ...................s.:.................................., ........................................».......................................
2. Owner's address ................./ .. ..... .................................. _..:,».`........,. _»............................» . ..................................
3. Architect's name .............1................................»..»................................_.......... ........_.,...,... ».......
4. Builder's name _2"...........` ......._. ......... ............................. ......... »........».......
5. Builder's address .......! ....`..4. ......... ......... ..... .. I...................'.........................» ......... .........................................................
6. Location of Building. Street No.
:...... ............»............ .............................................................................»..».....».....»...
7. Is this a removal or new building..............................................................................:....... ..... ......... •...:...... .....................
8. If removal, from where ..... Z ........................................................ _ ._ _......................................................................................
9. What is the purpose of building .... c ..... ... . . ................. ...... ......... ......... ...... ... ...».......».................
10. Material of building f.t tc: . : �.: ............!.�( ..... ;:,.... ..`........ ...'... .........» ...�a .+....: ....»::.
11. If a dwelling, for how many families ..........�'/.*,I._................
».....Number of rooms ...................................................
12. Is there to be a store in the building ..»':....»........,.........................................................»...................».............................................
13. Size of building, No. of feet front ...........»...........;No. of feet deep ........................: No. of stories .....................
14. Size of ell, No. of feet front ........................: No. of feet deep ......... i...........; No. of feet high ..........».............
15. Size of Lot ...»: ..».".....»...........................................................Feet Wide ..........,.....,.......,........... Feet Deep .................................
16. How near the-line of street ...................:................. ....................n..,.....,.,.........................»...............................»...............................
17. How near the line adjoining lot. Right ............I.......................3 ...r ,tt...................................; Rear................................
18. Nearest building is ..........»!...:................ feet in a...................................................... direction ......................................................
19. Material of the floor .WoQ.4...........................................................................................»..»......................................._............................
20. Size of timbers, 1st ........................: 2nd ............. ..., ; 3rd .......... .:.. ...; 4th .............................; 5th ................»».........
21. No. of feet span ........................._............._............................ ; Distance on centers ...................................................................»..
22. Will the building be erected on solid or filled land .. °: .?.:.. ........ :`...'....:............ ...............................................
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23. What is the material of foundation ........'-.. ........»....»....».................................; Footing .......................
24. Will the roof be flat or pitched .......... ......»........................................; Cove. irrg....................»....»...................»....................
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25. Heat; steam, hot water, furnace, stoves :�:.:.........,,_......... Power oil burner
................................................
26. Fireplace » .............. .. ......................................; Insulation .... ....»...............................................................................................
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27. How many sinks.... .......: Toilets ...........; Lavato ries .........; Bathtubs.........; Showers............; Settubs .........
28. City Service; Water`................... . Sewer .......................: Road Surface ......................... ; Sidewalk .................».....
29. Is lot on accepted street ... ....:...::.................. ............................ ».............».........».....»..............
30. Estimated cost (must be filled out) ............ .. .............................................................................._....».........................»..............
Applicant agrees to give the Inspector of Buildings 24 hours' notice before lathing or
plastering this building. This building will conform to the requirements of the law.
Signature of applicant y
No....... �Z .....
REMARKS
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............................................................«.............»...................................................,........»..»......................................................................»........................................
....»».».»...........»....................».................«.......».......,..............................................................................................,....................................................................................
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APPLICATION----FO-R--ZONING PERMIT
NORTHAMPTON, MASSACHUSETTS
NUMBER
DATE
'
NAME OF APPLICANT C,
ADDRESS i A 7 /6rz'cA-/clF
TELEPHONE (Home)-�' -S 4> tl-4 76 (Business) 56 0 -
LOCATION OF PROPERTY
'J""+ �kl�
STREET .
TAX MAP NUMBER WARD
PRESENT ZONING CLASSIFICATION
USE OF LOT, LAND PARCEL, OR PURPOSE FOR W1111-CH A ZONING PERMIT IS
BEING REQUESTED_
SITE PLAN REQUIRED NOT REQUIRED
DATE REFERRED TO THE CITY ENGINEER
DATE REFERRED TO PLANNING POAF,*3
DATE APPROVED
TO BE COMPLETED BY TFE ADM TNISTRATIVE OFFICER
DIMENSIONAL AND DENSITY REGULATIONS YES NO
SIGN PERMIT REQUIRED YES NO
DATE SIGN PERMIT !S,,,ULD
NUMBER OF OFF-STREEr," PARKING SPACES
NUMBER OF OFF-STREET LOADING SPACES
ENVIRON.,�NTAL PERF0-'.:4vANCE STANDARDS
SIGNATURE OF APPLICANT