43-052 (5) DEPT. OF BUII DING INSPECTIONS
- 212 Dain Street ��U�L��NG 0:z' ` �
Northampton, MA 01060 PERMIT
43 - 52 VALIDATION
DATE February 4, �, 9 85 to�R �ag° 64
APPLICANT Ralph C. Kellett ADDRESS 0 Home Owner
(ND.) (STREET) (CONTR'S LICENSE)
PERMIT TO Wrecking (_) STORY One Family R OF
DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 516 Westhampton RoadZONING
DISTRCT Sr
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE 22 FT. WIDE BY 30 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
Poultry (TYPE)
REMARKS, permit for the demolition of ENEUM building
AREA OR XXL 11100.00 PERMIT 10.00
VOLUME ESTIMATED COST $ FE
(CUBIC/SQUARE FEET)
OWNER Same as Applicant BUIL
ADDRESS Same as Anal i dant'c BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pj p
CITY OF NORTHAMPTON
MASSACHUSETTS
e OFFICE of the INSPECTOR of BUILDINGS
�1
Page Plot s_5-72_ APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, III, IV, and IX. O
ZONING
(• AT (LOCATION) �`'' DISTRICT
LOCATION NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
V1
II. TYPE AND COST OF BUILDING — A11 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)<On. 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— — — — --)w20 ❑ Industrial
30 Alteration (See 2 above) 14 ❑ Transient hotel, motel,
21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 Wrecking (1/multifamily residential, of units ——————— — —)� 22 ❑❑ Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional
Part D, ]3) 16 ❑ Carp ort 24❑ Office, bank, professional
6 ❑ Moving (relocation)
17 ❑ Other — Specify 25 ❑ Public utility
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 ❑ Private (individual, corporation, , r 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 ❑ Other — Specify
9 ❑ Public (Federal, State, or 6
local government) 1 x
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 I$
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 L:1 Masonry (wall bearing) 40 ❑ Public or pr' ate company
48. Number of oriel................
31 ❑ Wood frame 41 ❑� Private septic tank, etc.) 49• Total uare feet of floor area,
all f ors, based on exterior
32 ❑J Structural Ste di ensions
.....................
33 ❑ Reinforc concrete H. TYPE F WATER SUPPLY
34 ❑ Othe — Specify 42 Public or private company
50. Total land area, sq. ft. ...........
43 ❑ Private (well, cisnern) K. NUMBER OF OFF-STREET
PARKING SP ES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANI L 51. Enclos ......................
35 ❑ Gas Will there be centr air 52. 0 doors........................
36 ❑ Oil conditioning?
37 L. RESIDENTIAL BUILDINGS ONLY
38 CooZy
ii44 ❑ Ye 45 No 53. Number f bedrooms..............
39 I Otheci/y Wil ere be an elevator? Full..........
54. umber of
46 ❑ Yes 47 ❑ No bathrooms Partial........
IV. IDENTIFICATION — To be completed by all applicants Aw
Name Mailing address — \'umber, street, city, and State ZIP code Tel. No.
1.
Owner or
Lessee
Builder's
2. .V 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.
Sign t re 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 By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Dae Permit or Approval Check Obtained Number By Permit or Approval Check Obttaitned 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 y
Building- � ` C'~� Use Group
Permit issued c �] ( 19�
Building �/ Fire Grading
Permit Fee $ C
Live Loading
Certificate of Occupancy $ Occupancy Load
App by:
Drain Tile $ /
Plan Review Fee $
TITLE
NOTES and Data — (For deportment use)
Vill. ZONING PLAN EXAMINERS NOT_ES____
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