16A-020-207 (4) IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
I CA �`, f 9O , P4P / r � ,r � � t� 5 NOTES and Data — (For department use)
Owner or � dC �! G� �/'�
Lessee
ze7Ligezr Xu _ r /� I
71°/ LBcens e G/A,
Contractor n) 0,404ey y 43 . LdA
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 f applicant Address Application date
A 4 4" . *0,
DO NOT WRITE BELOW THIS LIN
V. PLAN REVIEW ECORD — For office use
Plans Review Re uired Check Plan Review Date Plans B Dote Plans By Notes
9 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $ i ■
OTHER $
—
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 r"
CURB OR SIDEWALK CUT ROOFING r
ELEVATOR SEWER
ELECTRICAL SIGN OR BILLBOARD
FURNACE STREET GRADES
GRADING USE OF PUBLIC AREAS ,
OIL BURNER WRECING ,
OTHER OTHER ,
. _ ,
VII. VALIDATION _
Permit number X FOR DEPART USE
Permi U ,
Building U Grou
l P
Permit issued )(di `01 19—
Bui lding Fire Grading
Permit Fee $ 91V1 � %� Live Loading
r r
Certificate of Occupancy $ Occupancy Load
$ � Approved b
Drain Tile 9 644°14:ILL -
Plan Review Fee $
TITLE
0 ` 4 1a CITY OF NORTHAMPTON
MASSACHUSETTS
VIII. ZONING PLAN EXAMINERS NOTES I At ` �, ;■
_8• t� a OFFICE of the INSPECTOR o BUILDINGS
.i /(u p
DISTRICT \ . P
e z � , . , .,..� Page ; Plot APPLICATION FOR
USE " - ZONING PERMIT AND
INSPECTOR
BUILDING PERMIT
FRONT YARD Z
IMPORTANT - Applicant to complete all items in sections: I, II, III, IV, and IX.
SIDE YARD SIDE YARD .v de. . , � . � / ZONING
wI - U I
1. AT (LOCATION) 2 . � $ L.4 2 DISTRICT
REAR YARD LOCATION (NC.) (STREET)
OF BETWEEN AND
NOTES BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
II. TYPE AND COST OF BUILDING - All applicants complete Parts A - D 1
A. TYPE OF IMPROVEMENT D. PROPOSED USE - Fo •'Wrecking" most recent use m
al
1 New building 1 1 9 Resid ial Nonresidential
2 I 1 Addition (If residential, enter number 12 O ne family 18 1 Amusement, recreational
of new housing units added, if any,
IX. SITE OR PLOT PLAN - For Applicant Use in Part D, 13) 13 I I number or more family - Enter 19 Li Church, other religious
PP number of unit's - - - i
■ . • • ■ • • • ■ ■ • ■ • . ■ • • ■ a • ■ • ■ ■ : 9 Alteration (See 2 above)
20 i Industrial
14 Transient hotel, motel, I
3
Iia : : I 21 C-1 Parkin
MO 1 to :.aNJ: 4 Li Repair, replacement or dormitory Enter number Parking garage
: •• a :N M N : a •= :r " : :i: N :a • • N■ Nr•N•!• .■: •N ■a•� y 22 1
rr■ = : ai Ne=•., :: :a i. a ■.N•aus• i..= :..:i 5 I Wrecking (If multifamily residential, of units - - Service station, repair garage
. e • N•t H■ ., r N ••s •
•1111• � .� ` • • rt■ = ••■ . .■ _ t. : = i !_h • •N ■NNN enter number o/ units in build; :ag in 15 � _ Garage 23 �� Hospital, institutional
N ■:: ■ ` Na : ■ : • j j *■ i fi j :a . a N ■ Part D, 13 ) r - - --
•r :ss:s . •' I. � s s �� ■ • • • : ■ta s L
: : :a::::•\ ■•11•.U:i. ■ : \ :•• : : l :.i `fir • a ■ :r::i :a:a : ra .ua: 6 Li Moving (relocation)
z41 I Office, bank, professional
Naha ••• •• aNr • • • 1t ■ • • •■ NNa 16 � Carport I.
=::a a :N ■ia a u : i ::i : :r • t it ► :: Ni•�rr:a :N•�•/�r•a aua•�r��ra�•p •S q :min -- Spe cify _� -- - _ 251 J Public utility
•■ :• :r : •.
:e• :i • a as :N•:• NN :a: ara Nr • ■ N ■fa.N•sNN M■ NH a Q pas a a 7 I 1 Foundation only
_...m u.• •e: :u• :$aeu.s ,: : :s :aa : : : : : :.$..u.s:: • r a..a•.■ v
26 1 School, library, other educational
• ::::a•:::::■ •� • • ii :1 • :•■ • N r w • rN• iN = y ,*) 27 Stores, mercantile
sleras�--. ; : : :N :. H ' aa....�. ��' ■N.a ■ ■a . f/°
a i �NU : i :: i=Pi.'� ` Sia•i '�i' "fir• :•N: :r.ar'i'rri�: i i : . B. OWNERSHIP 4,1 f ,
H N•aa � a• •• •a • N • • • 1 t1 :
•r
a r S: •�aaS�aStri�r=: r a a`; ■ s. a' is :■N`•atar•iraaN"aps•••NNN•Naea �g�:a
rii: : :a _
: 8 private (individual, corporation, 28 `_j Tanks, towers
as NeN : :,:: 3141i:i11•i :,1 1a■N ri1 a•• Nr■: 2H •N■ ii r•■a« :� ....•aa�Na 1 29 Other - S ec7
1: � u . :: •• • ri :•■Naa ..... r ■• aN nonprofit institution, etc.) _ Li p /y
N.NarNNN• • • !!_=! • 111 N•r•a• ,, N • ■.• t`rINN •••.•N
{i•:
:••Nai::•::: " " '11 11 :• 111 N oar ":its N■N■ta • • ::a. ■'ak: :ara
: =:a: •ti `•a : 1.11. N ::
• •N N •� N• Li Public (Federal, State, or
# :::: a ::tl:::■r • e..... : :a:aa • i• :: aN. ■NN N•:aara local government)
i:: :iwe : :.r::i : \r : i a ' r =iNNrN a iiffai \ i= :• :: tai :: : t7■: Nonresidential - Describe in detail proposed use of buildings, e.g., food
::
: a• :a : = s C. COST (Omit cents)
:1: p •a.::• is r:••.i. : : :N•sa: :r : ... as : _ processing plant, machine shop, laundry building at hospital, elementary
••11• �r1•• .N :r.. : : rii:ii::iiii. :� : =s :::: : 10. Cost of improvement $ �/ I i school, secondary macro college, parochial school, parking garage for
••N• ar•� \N•• ■ ■tera :rrae: NaaNr ■• • t1 \ ■• • ■11111
1221 aa•N.N .0 .•eu•N.a.•r
:•N department store, rental office building, office building at industrial plant.
•. NN • • • • •u i : r a • • ■ ••■ : 7'o be installed but not included If use of existing building is being changed, enter proposed use.
••r ••N.•••• :•r • ••. ••. ••■• • • ••
:: • a• •r a :r N ::a aa : :r:: •• oa �•••• • •••.••••.. •N•N•NN••••••• a : in the above cost � ��` �r G ���L� y ,� .
a . " • : '... :12:::: :' "` .. . .z: : : 1: :.... .... a• 411,(JA (3 t {/ / r 22 /3
■ !- • :11: :•11 N • •■a• :!N• ■ : •:a: .: L : : a. ElectricaI ^ �A
a• R •t • . .:.. N a a r :. •ea• , N.. ■a r is
• .■M r•� •a .■ : : :4 :: • •� •
am mess N \ ■N ■•NON ■•N• ar ra ■ : :
: s •...s
..:•. . ... r ra N • Ir* b. Plumbing A NNa.• Ilra a ..rr : a if : •NaaN : "O
S
1 : :r: iiiii" :a:: r g : :i:` ......::•s •:: ai' N• ■..•• •............1::::::
ear■ c. Heotin air conditionin
li`:$::::sa:s:::::6:4: : s ;a.•=r : :memo: s g
• •• �r ail eaa: gn : ; :m _ a• i a a =.a :�.a= : = e aN ::: d. Other (elevator, etc.)
■�• i'■i• ; _ � i " • i t•.`•: a .S 11. TOTAL COST OF IMPROVEMENT $ y�
r ■ • •N : ■ r• N N: .r •
1::::441,01,10i: 1 : r : z:z•a :11:. ::Nii N . :lorzaa■ .: ■:: a : •a :::ii :.a ■: a s
i':: • r . H.a: • ' : : N ' : • a •• : :`ii:
• : :: :a : :m r o ::i=
••r :::aa:a:::::::::: : III. SELECTED CHARACTERISTICS OF BUILDING - For new buildings and additions, complete Parts E - L;
i : a \.r i • a■N:: a•. r: :::::::::::...:u...: N .a • ::•r
�: E ■. : : r : .a ■ :■ : • • :a■ : : ::: :: :: • ::::: ::::: a .. ••• r for wrecking, complete only Part J, for all others skip to IV.
$ :.::::! ::al::=ar : : : :n :gzry :: : :r:s::i•a:s•.ssa•a a •:•s y. ■r :s:.zs.s ;: : : i :■.•::.: s:
:r: ■ ::•:•:::gu :• :i t:• :::::s: : •=alt.• ra :rrr.r N• ::: :: ::... . rm.. i 11::::::::::::' ::::::::: :::::: E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
• ■ • 11
:a :si ::z: z :. : saiiiira::. . :N ■i . • • r :
N :Na •• • `i`i s a■ : :� : a
:
•.ua. 48. Number of stories
e :_: a• :::::: :a si� ta :a : :a
au R a:: • N•NN ••s. ••` 30 1 j Masonry (wall bearing) 40 1 1 Public or private company
�• • .e •iN ••N : \•i N r a: ••: : : r NN •
: . 49. Total square feet of floor area,
i ii iii= Lii= a= iii :i=1..N•1ii1 ■:: :- .4 : : : :• i :• r= :s: : : :r ... : 31 I Wood frame 41 H Private (septic tank, etc.) all floors, based on exterior
:: ■• •• •N •a • • •• *
S•Sj `ate • � :sa a:• • :oin •: : : ::N :::1:i..............1.:...:....: : 32 LJ Structural steel dimensions
•• : :1 . j• •• • •• . . 111 • • . . a .....111::::::.:::::::::::: •
is a: : _ ::. s:s. :I:sa• :i : a a : ■ • :1ss:s1ra1: s.
N H . TYPE O F WATER SUPPLY P P L Y
• • • •NN NN•••t1■• • • ■1 ! ■ ■.
� t = _ : a : • • s :: \ : •. a •• • • : :1 r rsaN 1 , : 11 `11:• 00.111..=..0.410111.2. rr. �: • .ro ar; 33 1 1 Reinforced concrete q
: • • ■•a . :• • • a • • ■■ • • 111 1 : :a :a:: : :a1 : 50. Total and area, s ft.
i• i :: rs::: a$ I r:: i 3: sa i� r .•. r a srr .r• a r r a :. :aaa : : : ar s:s•.:aa:.sa =NN= 34 1 Other - Specify 42 1 Public or private company
:: s $ : : :$ ■1 :: ••. •t:: ai : :.�z :: _ :• ■H :: ::1
« *;-711111111111111101111111111.%. 43 1 Private (well, cistern) K. NUMBER OF OFF- STREET
NI MO !z ::: ss:a::: s ..:... F:a:sara::a.. ■■..NORM
1.1111 • �i�11i ::isriiii1ii•i11 1�1a: r: rra.. N•r : rn a= ap�a:::::: ::•i : :■■• :r : :iirr :a : :a :•a:::::a Y r PARKING SPACES
51. Enc osed
• ■ ii • a•a • °a N • s i :r ■ •
1111111111111111111111111 , ii1 sa1:: ..rr.s::asazs... i ..s :ss ...a si:
* 1 Imo Y: }` t i , ■ra a m . . N■ F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
ss: s1als:r: ...s•a...srs sas::a
s a : ...
J1, e T ' 111 : "a 1 111 11 a N N r::.rr. :111111 :1111: a 35
{ ++ ■ t fie ' r tt � 1 a � � . � �� ■ ! j ',� � r � • ■� �'j��ra ■ N ■ • Gas Will there be central air 52. Outdoors
i f y ;i • : • e n f }' - Z'" * ;'t 1. t ♦ ! 1 siiilihi iii �i1iiii ► ::!Bill fii:r1iilliiiiiiiiiri : : :U :rr=u • conditioning? '
t $t f4 Y. a ;�sig:"� 11 11 s• ' ss m a :rya ::::: _ 36 Oil _ L. RESIDENTIAL BUILDINGS ONLY
,t; l'11111111111111111111111111141'
1( I f 7 {7 j I i r $ � � t '{ l� t , j _��j� ` __ �■ �__ = iiiiiii � . .ss a.`lt = ` 38 1 Elecfricit �� No
1 I11 i :ism11l11imm: iL 11 1 11 ■ • •NN Y 44 Yes 45 53. Number of bedrooms
� * rt fttt t • • <
z i; � � i , a r _ r * t t t ,t is :: m:11'.. i :•::::• Pia
TT ,' I _ :: 11111114111 '' , _.. .. ` ttl' " , .' "..!.l.. .=_ .. :.....1:11:4 �l:ar:aN...N: .. 39 1 Other - specif Will there be an elevator Full
54. Number of
46 r i Yes 47 , No bathrooms
Partial
P'P