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No. Owner or `� �Fi r�^� �`i��,c `.✓ !y� ( "( :/ 1 / 4� / /'l..0 i'lq� / - / ( � ./OV ` Lessee Builder's L. ��� License No. Contractor 3. Architect or - — __ __ Engineer 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 DO 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 Permit or Approval Check Obtained Number By Permit or Approval Check OblDained 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 � ,��� Permit number Bui (ding Permit issued � _G.�.�� � 19 Bui (ding Permit Fee � �/,�� t.'� t� Certificate of Occupancy S Approved by: Drain Tilea Plan Review Fee S -� -�... i.., C�iz��r a� �o�tt��nt��n�t r�l F .i r� =., �' a��k -y� f®ffice of the �rts}r�rtur of �uilDings —�'- APPLICATION FOR Pa a :�.��- Plot °"-� -� ZONING PERMIT AND ��� . � � BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. Z _ .� O I• AT (LOCATION) �!� / ��%�y°..�fT:C.�C..^ ZONING r' ;� DISTRICT /' �iJ LOCATION (N0.) (STREET) �F 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 1 I � New building Residential Nonresidential � 2I I Addition(IJ residential, enter number 1p� One family 18 Amusement, recreational of new housing units added, iJ any, in Past D, 13) 13 � i Two or more family —Enter 19 Church, other religious number o/ units— — — — --> 20 Industrial 3 � Alteration (See 2 above) lq I � Transient hotel, motel, 21 Parking gorage 4 Repoir, replacement or dormitory — Enter number 5 � I Wrecking (1J multifamily residential, of units — -� 22 Service station, repair garage enter number of units in building in 15 I ! Garage 23 Hospital, institutional Part D, 13) 6 I Moving (relocation) 16I I Carport 24 Office, bank, professional 7 � I Foundation only 17I I Other — Specify 25 Public utility 26 School, library, other educational B. OWNERSHIP � 27 Stores, mercantile B�Private (individual, corporation, 28 Tonks, towers �r 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, mochine shop, laundry building at hospital, elementary 10. Cost of improvement $ /�; f, -�,i --�'� school, secondary school, college, parochiol 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 $ � / G`�� � III. SELECTED CHARACTERISTICS OF BFJILDING -For new buildings and additions, complete Parts E - L; � for wrecking, complete only Port J, for all others skip to IV, y E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS te r.., �, m 48. Number of stories � `� 30 L � Masonry (wall bearing) 40�Public or private company 31``� Wood frame 41 I I Private (septic ton k, etc.) 49. Total square feet of floor area, all floors, based on exterior � ��.. 32I Structural steel dimensions �.�.:� �}. ���lj�`;, ,.� 33 � � Reinforced concrete H. TYPE OF WATER SUPPLY �`� 34 I 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 ..... .•- 1.-ar� / 1� 35I � Gas Will there be central air 52. Outdoors ,�e4 -.... ,�_ O 36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY `� 37 Electricity 44 I I Yes 4� No 53. Number of bedrooms 38 I I Coa I 39 I I Other — Specify Will there be an elevator? Full ,�./ 54. Number of 46 I I Yes 47 IXI No bathrooms f —v, Partial DEPT. BILE COPY �'ITY OF N ©RTHAMPTON � o NCz?TH�1�T4N, MAC. Oi060 BUILDING as PERMIT VALIDATION 23�a — �3 DATE December 5, 19 77 PERMIT NO. J79 APPLICANT Jeff2"F'y nOd ADDRESS • - a - v - ` r- - N�.) (STREET) (CONTR'S LICENSE) PERMIT TO Alteration to residence 2�- STORY Residence DWELLRNG UNITS (TYPE OF IMPROVEMENT) N0. (PROPOSED USE) AT (LOCATION) i�7 Federal D STR CT unB (N0.) (STREET) a BETWEEN � AN❑ � (CROSn STREET) (CROSS STREET) a LOT m SUBDIVISION LOT BLOCK SIZE a O BUILDING IS TO BE FT,. WIDE BY FT. LONG BY FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION O m O / Z TO TYPE USE GROUP L. r BASEMENT WALLS OR FOUNDATION � (TYPE) K O 1� R E MA R K5: nS - I _. _ �. !. � .. ,1 • R ' a I • s a - e : • ass u rranklin stove to existing chimney, general repairs if necessary, new hall, etc. AREA OR PERMIT VOLUME ESTIMATED COST .� i�00� FEE � 10�(}Q (CUBIC /SQUARE FEET) OWNER Jeffrey Mood � � � >� ADDRESS �i-t�9 FPfjP_Y'Fl.� .�}�',rAP1'� � �A��,10.p'tO�r BYILDI DE - .- - — ` � (,®,�#idavit on reverse side ®# ap�slicataan to ire completed by antis. ed agent of owner) w� � CERTIFICATE ISSUED DATE k��� �" f,e` 1 BUILDING PERMIT - CERTIFICATE OF OCCUPANCI� DATE � .�"rt 19 l� PERMIT NO. APPLICANT ,�� '� ADDRESS '� -�y �:_,�;.. -_�" ;�,�.,:,�.:�, (N�.) (STREET) (CON7R'S LICENSE) PERMIT TO �'�� - �'�'�r(�„ STORY *.�"��' DWELL UNITS �* (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) « ZONING AT (LOCATION) a* � DISTRICT (N0.) (STREET) rn BETWEEN AND � (CROSS STREET) (CROSS STREET) LOT a SUBDIVISION LOT BLOCK SIZE m � BUILDING IS TO BE FT. WIDE BY FT. LONG BY_ FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION O m O t Z TO TYPE USE GROUP � � BASEMENT WALLS OR FOUNDATION � (TYPE) ll O REMARKS: ? ''$ %_: # s:s a #,➢�t .. ;� �.t�a.. �. �.t.�.�:. It a�t.:va� � w� .s .. .._�« �C�I s� '� '�-�! ' -�[ A'�I � '. �I QC�1 �Cfl ��I �i K�I '•: - �I '? � � ;i AREA OR "INt. ;tll1 :nUl ;Iln IIII IlU 111 _ p :I � iln Ilnt Iln VOLUME (CUBIC /SQUARE FEET) � �� `� �� ?� - � �i � ?u yt 11=1 � � rd `1111 ;I.H1 ;ills ,I III .1111 Jl lll ;1111 :1111 ' _1111 ;1111 ,1111 , )1111 a��lll ;1111 :1111 �YTT I .V Cf i bT.'/I vt-tl Io�TTI A'C711o�T71 A'T1f A'Cll A'L'> V TTI ,{r TTI 1d TT1 �O�rn aTll A�St1 A� E OWNER �� � �0 BE POSTED.OX� PREMISES: � -' t ,,��,� ������ SEE REVERSE SIDE FOR.CONDITI.ONS- �QlgCERTIFICATE [( ADDRESS � I ,. , (��• ., _.