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11A-071 (2) FORM NO. BOCA-BP 1969 D O > a<D m 0 m C m > m D 3 r o -1 3 r m m 30 m -a _o f — 11 n N w mx m 0 N m o H z N z z - o Q � d Po O • o ? N i • • m .a K • • t m o Li _ p' ,- _s 1 Q w. • m 0 1 \ O c _ 0 Q+ m .I m : • ( 0 p o m m m • Q m • m In v ,9 m V -< -4 _� p o H ti D m ' = z m En -• v • 1d ti w FD • A -I H VI• o o °0 O 0) • m 0 �• m CD t -{ Sy 11 D i� N m 1� < N y� • �l a • m 00 m T m F. z D r/ C o --I Z v o 0 C+ f m o m _ n9 O 1D 1�• > r .° • = 1 m r o N.• co v {{} n 7c m CO M 1 0 O ,n• w it m co r `-4 • z m • 13• <c 0 r y ' m Q i — � 1 Q \A z AMOUNT o x PAID z m m (Y Nr 1° (D P O o 3 x m� A . -� C • D m oz H i, -- .i O z cn m3 . N N rm 0 Q CA x in —m rn V > -1 z , 1 r 0 0 D ••i T10 ...1 • r m p N Cm r -131131 C) -a 0 ? W m - o N z V o r 3 • < xz N s - m v - � I—I , m 3 L'7 f� Z In • O chi o — U, • 'FY • z Q Q • - m c z n ^ \ m 1 O I z IV. IDENTIFICATION — To be completed by all applicants Name Mailing address — Number, street, city, and State ZIP code Tel. No. O wner or {IRK S /Al[MAA/A E L =Nl i Cl �� ! Lessee Al0 ro AA 7-0/v Builder's 2. ('/it < S V tk)S i+ fIli 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. Signature of applicant Address Application date e..%5 l x ,✓a�, /f r T,_-- i 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 9 Fee Started y Approved y BUILDING PLUMBING MECHANICAL ELECTRICAL OTHER VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Date Permit or Approval Check Obtained 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 3f%2_ j Building Use Group Permit issued /3 1972_ Building Fire Grading Permit Fee $ (0003 Live Loading Occupancy Load Certificate of Occupancy Appr• ed by: Drain Tile (4.\ . w Plan Review Fee TITLE f NOTES and Data — (For department use) #111—!41/ 4 _J/t. j `j, CITY OF NORTHAMPTON OFFICE OF THE INSPECTOR OF BUILDINGS 212 MAIN STREET APPLICATION FOR NORTHAMPTON, MA. 01060 / PLAN EXAMINATION AND f f 7/ BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: I, II, Ill, IV, and IX. 0 _ A, ONING { /� I. AT (LOCATION) F+- �.Llv 77-=_W Si .�• DISTRICT R_�f�•"j' LOCATION (NO.) (STREET) OF BETWEEN AND BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE -,e", Pit'( y.. P 2. N II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D —1 73 A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m m 1 New building Residential Nonresidential 2 [ I Addition(If residential, enter number 12 1;4 One family 18 I Amusement, recreational of new housing units added, if any, in Part D, 13) 13 I I Two or more family — Enter 19 Church, other religious in number of units— — — — --> 20 I Industrial 3 I I Alteration (See 2 above) 14 I I Transient hotel, motel, 21 I Parking garage 4 I I Repair, replacement or dormitory — Enter number 5 I Wrecking (If multifamily residential, of units — —0- 22 I Service station, repair garage enter number of units in building in 15 XLGarage 23 Hospital, institutional Part D, 13) 16 I I Carport 24 I Office, bank, professional 6 I I Moving (relocation) 17I I Other — Specify 25 Public utility 7 I Foundation only 26 I School, library, other educational B. OWNERSHIP 27 j Stores, mercantile 8 *fl.. Private (individual, corporation, 28 Tanks, towers nonprofit institution, etc.) 29 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 $ 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 _$ Z ' ()Cr 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 J Masonry (wall bearing) 40 Public or private company Number of stories 31 Wood frame 41 I I Private (septic tank, etc.) 49. Total square feet of floor area, tit; 2.`- all floors, based on exterior 32 Structural steel dimensions j5 33 Reinforced concrete H. TYPE OF WATER SUPPLY 34 I I Other — Specify 42 K Public or private company 50. Total land area, sq. ft. /I c r 43 I I Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed i F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 35 I I Gas Will there be central air 52. Outdoors 361 I Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37 I I Electricity 44 I I Yes 45.N No 53. Number of bedrooms - 38I Coal 39I Other — Specify j",--L,91 NA..1) Will there be an elevator? Full E 54. Number of 46 I I Yes 47.RI No bathrooms Partial L. '