11C-009 (2) DEPT. FILE COPY
BUILDING 0a
/`C_y PERMIT VALIDATION
DATE 19 r PERMIT-NO.
APPLICANT ADDRESS
(NO.) (STREET) (CONTR'S ICENSE)
/ ' NUMBER OF
PERMIT TO ''�t (___) STORY / DWELLING UNITS
( YPE OF IMPROVEMENT) NO. ( (PROPOSED USE)
` ZONING �/,��.+��7 d
AT (LOCATION) ,-� DISTRICT UYE
( 0.) (S R
a BETWEEN AND
0 (CROSS STREET) (CROSS STREET)
cn
LOT
n.
m SUBDIVISION LOT BLOCK SIZE
U
O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
co
O
Z TO TYPE USE GROUP I". , WALLS OR FOUNDATION
2 (TYPE)
CC
IL REMARKS: .74' 4� 1
AREA OR PERMIT /2 --t7
VOLUME_ ESTIMATED COST $ FEE $ U (2
(CUBIC/SQUARE FEET)
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OWNER !/ ! / /�� BUIL■ NG D;T. /
ADDRESS L - BY _ -��
C -
(Affidavit on reverse side of application to be completed by au named agent of owner)
IV. IDENTIFICATION — To be completed by all applicants
yq��BNa/mme /! Mailing address — Number, street, city, and
y/�Stt ateeC " ZIP code pTel. No.
Owner or �i" :444: / ?,4°�l 1 L(ff.BXY J i'Z ✓/:y 5 aia a 4/-/
Lessee /� fs��
2. ,70144 A sC f/a Bui I d e r's
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 x./4 Application date 27, 7-7-
, faa} (8. zi-f-e-nL
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
Date 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
Building Use Group
Permit issued .�• 19
Bui[ding
Fire Groding
Permit Fee _ "._..` Live Loading
Certificate of Occupancy Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
IT
NOTES and Data — (For department use)
GAG
CITY OF NORTHAMPTON
Iii �t 7
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 .— PLAN EXAMINATION AND
��3''Z' 11e BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, II, III, IV, and IX. O
/ n
ZONING
I. AT (LOCATION) jj�� DISTRICT `�
LOCATION ( 0.) (STREET) "S*"."OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D —I
xi
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
m
1 I New building Res'dential Nonresidential
2 I I Addition(If residential, enter number 12 One family 18 I Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 Two or more family - Enter 19 I Church, other religious {�
number of units- - - - -� 20 n Industrial '.....4:)
3 I/j Alteration (See 2 above)
14 I I Transient hotel, motel, 21 Parking garage
4 PIN Repair, replacement or dormitory - Enter number
IWrecking (If multifamily residential, of units - --)- 22 I Service station, repair garage
enter number of units in building in 15 I I Garage 23 I Hospital, institutional
Part D, 13)
16 I I Carport 24 Office, bank, professional
6 I Moving (relocation)
7 I Foundation only 17 IX Other - Specify 25 Public utility
26 I School, library, other educational
B. OWNERSHIP i'i,A.- It ` 27 I Stores, mercantile
8 Private (individual, corporation, j
28 I Tanks, towers
nonprofit institution, etc.) . Alsrryrtmi — ..PArat 29 I Other - Specify
9 I I Public (Federal, State, or
local government) ^n
C. COST (Omit cents) Nonresidential - Describe in detail proposed use of buildings, e.g., food t /1
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement $, ,e)/9j ---- school, secondary school, college, parochial school, parking garage for,
1.
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 $ ,„ '‘.210/, '—
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 Masonry(wall bearing) 40 Public or private company 48. Number of stories
31 Wood frame 41 Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 Structural steel dimensions
33 I I Reinforced concrete H. TYPE OF WATER SUPPLY
34I 1 Other - Specify 42,Public or private company 50. Total land area, sq. ft.
43 I I Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES '462_
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed n
35 I I Gas Will there be central air 52. Outdoors 2'—
36 Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 I Electricity 44 I I Yes 45 A No 53. Number of bedrooms
38 I I Coal ,
39 I I Other- Specify Will there be an elevator? Full
54. Number of
46 I I Yes 47 X10 bathrooms
Partial