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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 C19112-8,2.4.7040 //44 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 6-cS- Building. r Use Group Permit issued r > . ', 19 X` Building Fire Grading Permit Fee $ /l Live Loading Certificate of Occupancy $ Occupancy Load Approved by: Drain Tile $ Plan Review Fee $ rag --'2 CITY OF NORTHAMPTON 9����=��,,;I MASSACHUSETTS ■• ....�� `• ,(4 . OFFICE of the INSPECTOR of BUILDINGS Page ? (2- Plot /Pr APPLICATION FOR ZONING PERMIT AND INSPECTOR BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: I, II, Ill, IV, and IX. �� 0 ZONING �/y's /lam/ I. 3 , ZONING C'E. Sy AT (LOCATION) LOCATION (NO.) (STREET) OF BETWEEN AND BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE V1 II. TYPE AND COST OF BUILDING - All applicants complete Parts A - D -I A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m --I 1 I I New building Residential Nonresidential 2 I Addition(If residential, enter number 12 Li 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 1 I I Church, other religious number of units— — — — -0 0 Industrial 3 Alteration (See 2 above) 14 I I Transient hotel, motel, 21 Parking garage 4 I I Repair, replacement or dormitory — Enter number 5 I 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 Li Hospital, institutional Part D, 13) 16 I Carport 24 Office, bank, professional 6 Li Moving (relocation) 17 Li Other — Specify 25 L_i Public utility 7 Li Foundation only 26 I School, library, other educational B. OWNERSHIP 27 I ] Stores, mercantile 8 I Private (individual, corporation, 28 I Tanks, towers nonprofit institution, etc.) 29 L i_ Other — Specify 9 Li Public (Federal, State, or local government) C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food `y processing plant, machine shop, laundry building at hospital, elementary 10. Cost of improvement $,9� 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 existing building is being changed, enter proposed use. in the above cost ,i a. Electrical ' , - ii,. '' '_I .--742V b. Plumbing c. Heating, air conditioning d. Other (elevator, etc.) ,*, ,u y 11. TOTAL COST OF IMPROVEMENT $ 3 (! ----- 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 I I Masonry (wall bearing) 40 Public or private company 48. Number of stories 3 • Wood frame 41 Private (septic tank, etc.) 49. Total square feet of floor area, all floors, based on exterior 32 1U Structural steel dimensions 33 I I Reinforced concrete H. TOF WATER SUPPLY 34 I I Other — Specify 4 Public or private company 50. Total land area, sq. ft. — — 43 I I Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed 35 ■ Gas Will there be central air 52. Outdoors 36 117■11 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY H lectricity 44 Li Yes 45 No 53. Number of bedrooms. 38 I ] Coal 39 LI Other — Specify Will there be an elevator? Full 54. Number of 46 L _I Yes 47 I No bathrooms Partial . P• Department of Building Inspections g BUILDING N G 212 Main Street 20 Nort ampttn, Ma, 01060 PERMIT Qa / /[i 32C - 108 VALIDATION DATE October 7, 19 82 PERMIT NO. 558 APPLICANT Whiting Oil row. ADDRESS (NO.) (STREET) (CONTR'S LICENSE) • PERMIT TO jl ay Chi ey (. 1 I STORY p A p h NUMBER OF 1( T Eit m t I is StoS chimney DWELLING UNITS TYpE 0 IMPROV ENT) NO. (PROPOSED USE) ING AT (LOCATION) 16 Smith DIOSTR CT SI (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: Metal bestos chimney VOLUME ESTIMATED COST $ 300.00 lair" 10.00 (CUBIC/SQUARE FEET) OWNER Ralph ThOmpSOn / BUILDIN •EP . / ADDRESS 1F smith St_ Northampton, -Ma� 01060 BY _.'`.: WHITE - FILE COPY • GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY