24C-072 2.'1 G--- 7 2--
VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT U ,2 /3
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FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
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BOCA FORM APEBP - 669 C1969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
NOTES and Data — (For department use)
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IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Cumber, street, city, and State 7IP code 1 No.
1. d /1 J . S Y ,'I Arr c ! l l $ a/o o W1' -•traf
Owner or /� / �J f � � A A � p �i
Lessee i1/ d b E/fif A/ r!//mi �(/ � As-s:
/� Builder's
2.
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.
Signae of applic Address Application date
6 917,40
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
q Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Permit or Approva I Check O btained Number By Permit or Approval Check Obtained 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 c) ,3 (p
Building .
Use Group
Permit issued n 19,
Building Fire Grading
Permit Fee $ /Q, 40 Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $ /
TI E
n
• ` CITY OF NORTHAMPTON 1. !►�`�„ it- ' MASSACHUSETTS
wI 40 .
:,,� _ OFFICE of the INSPECTOR of BUILDINGS
�'� Page - C_ Plot 7 APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, II, Ill, IV, and IX. 0
I. AT (LOCATION) / + �� DIISTR CT��r�)�
LOCATION (NO.) CCC (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
VN
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D -I
73
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For "Wrecking" most recent use m
-I
1 I New building Residential Nonresidential
2 Addition (If residential, enter number 12I One One family 18 I I Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13JTwo or more family - Enter 19 I Church, other religious
number of units- - - - -0- 20 Li Industrial
3 I I Alteration (See 2 above)
14 I I Transient hotel, motel, 21 LL Parking garage
4 I I Repair, replacement or dormitory - Enter number
5 I Wrecking (If multifamily residential, of units - . 22 I I Service station, repair garage
enter number of units in building in 15 I Garage 23 I Hospital, institutional
Part D, 13)
16I Carport 24 I Office, bank, professional
6 I I Moving (relocation)
17 Li Other - Specify 25 Li Public utility
7 Ti Foundation only
26 I School, library, other educational
B. OWNERSHIP 27 I Stores, mercantile
BY Private (individual, corporation, 28 I Tanks, towers
nonprofit institution, etc.) 29 Li Other - Specify
9 I I 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 $ ta 6'or. 0 ♦ 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 e isting building is being changed, enter proposed use.
in the above cost
a. Electrical G � % n
above
� / x / f ,
b. Plumbing A(0
c. Heating, air conditioning Yd
d. Other (elevator, etc )
11. TOTAL COST OF IMPROVEMENT $ U 0
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
48. 30 I I Masonry (wall bearing) 4O Public or private company Number of stories
31,, Wood frame 41 I Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 Structural steel dimens ��
33 1 I Reinforced concrete H. TYPE OF WATER SUPPLY /1 ,r/7
34 1—I Other - Specify 4 "MI Public or private company __ 50. Total land area, sq. ft. —
43 • Private (well, cistern) K. NUMBER OF OFF- STREET
PARKING SPACES
51. Enclosed .‘"?..""
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL /�
35 I[ I Gas Will there be central air 52. Outdoors ..L.a..o
36y1 Oil conditioning?
L. RESIDENTIAL BUILDING NLY
37 Electricity 44 1 I Yes 45 IX J No 53. Number of bedrooms ... BUILDING
f
38 I I Coal f� �j
39 Li Other - Specify Will there be on elevator? Full """"
54. Number of
46 Li Yes 47 IA No bathrooms
1rt �' Partial