32A-183 (11) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
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BOCA FORM APEBP — 669 C1969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
41 x,41 A/rUA !�/� �
Owner or
Lessee / �/
2. L LtlL `Z /'TIV K�=� $/` /i� LgcenserN $/
C�rfsac to 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
06 NOT WRITE BELOW THIS LINE J
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
Approval Check Dare Number Permit o Approval Check Date
Permit or A umer
pp N b B Obtained y P it r A pp Number By
y
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 ^9 9
Building q Use Group
Permit issued o 67Go( 19
Building Fire Grading
Permit Fee $ �� �- Q Live Loading
Occupancy Load
Certificate of Occupancy
�pptred by:
Drain Tile < r \'
.�'
Plan Review Fee
TITLE
NOTES and Data — (For deportment use)
CITY OF NORTHAMPTON
OFFICE OF THE INSPE SOREOF BUILDINGS ,¢ APPLICATION FOR
NORTHAMPTON, MA. 01060 / PLAN EXAMINATION AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
I•
ZONING
AT (LOCATION) L f t �D� � � /1
DISTRIC
LOCATION (NO.) (STREET)
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
2 ❑ Addition(If residential, enter number 12 ❑ One family 18 ❑ Amusement, recreational
of new housing units added, if any,
in Past D, 13) 13 X Two or more family — Enter 19 ❑ Church, other religious
3 Alteration (See 2 above) number of units— — — — -->- (Z_ 20 ❑ Industrial
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 Carport 24❑ Office, bank, professional
6 ❑ Moving (relocation)
7 ❑ Foundation only 17 F-1 Other — SpeciJy 25 ❑ Public utility
26 ❑ School, library, other educational
B. OWNERSHIP 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.)............
UuC�
11. TOTAL COST OF IMPROVEMENT is
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 ..Z_
30❑ Masonry (wall bearing) 40 Public or private company 48. Number of stories................
49. Total square feet
31 Wood frame 41 ❑ Private (septic tank, etc.) Floor area,
all floors, based on exterior
32 Structural steel dimensions .....................
33❑ Reinforced concrete ` f �C H. TYPE OF WATER SUPPLY
34 p;;A 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 dN0 53. Number of bedrooms..............
38 Coal
39❑ Other — Specify Will there be an elevator? Full..........
54. Number of
46 ❑ Yes 47 ❑ No bathrooms
Partial.......
hereby certify that the proposed "work is authorized by the owner of'record-
and I have been authorized by the owner to make this application as_ his _
authorized agent.
SIGNATURE OF A`dEN
T
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED .BY TITLE
DATE 19
e .
i
DEPAR=T OF BUILDING INSPECTIONS z a DEPT. FILE COPY
NORT�TO MA. 01060 BUILDING `a
■ ERMIT VALIDATION
32A - 183
DATE June 22, 19 79 PERMIT NO. 29j
APPLICANT Al X Ta -tnwj n7. , supervisor ADDRESS 80 Barrett St. N' ,on.
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF b
PERMIT TO Alter & re-pair ( 2 ) STORY trusses on flat roofs DWELLING UNITS 8
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) Br-i dge 11(rnnl l rigp pt� 11 DISTRICT URC
(N0.) (STREET)
a BETWEEN AND
b (CROSS STREET) (CROSS STREET)
LOT
a SUBDIVISION LOT BLOCK SIZE
M
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
(TYPE)
D:
0 REMARKS: PPr i l an9 1)ii ' an fl at ran-fs
AREA OR
VOLUME ESTIMATED COST $ 11 .00D FEEMIT $ 3,3.00
'(CUBIC/SQUARE FEET)
OWNER Jem Associates
ADDRESS 45 Canton Ave. , Amherst, Ma. BY
I IN Pr. l
(Affidavit on reverse side of application to be completed by authorized agent of owner)