32C-109 (4) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE •,• i
REAR YARD /
J'
NOTES e /
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BOCA FORM APEBP - 669 CI969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
NOTES and Data — (For department use)
1,4r(--Zoito , 9111/W 216'/) r": 6/4
1
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP eel No.
1. OAd ! 7!' L/ 6 U[Uo� J
Owner or
�
Lessee
��
essee
��"" Builder's
License No.
Contractor q,��d.ai
3. (�V//�
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
( AP 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
ate Permit or Approval Check ObDta ned 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
number G 1y FOR DEPARTMENT USE ONLY
Permit
Building.
19a, Use Group
Permit issued ��
Building Fire Grading
Permit Fee $ LCD,_Oei Live Loading
Certificate of Occupancy $ Occupancy Load
d by:
Drain Tile $ al;P , ,
Plan Review Fee $
TITLE
(1, 1-4.4-,
CITY OF NORTHAMPTON
I N';,i1 MASSACHUSETTS Al
� �, li OFFICE of the INSPECTOR of BUILDINGS•
� Page _3-2- Plot / 0? 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
I. AT (LOCATION) DISTRICT��
LOCATION (NO.) (STREET)
OF 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 -I
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
m
—I
1 1 1 New building Residential Nonresidential
2 I Addition(If residential, enter number 12I I One family 18 I I Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 I I Two or more family — Enter 19 I Church, other religious
number of units— — — — --)p- 20 Li Industrial
3 xi Alteration (See 2 above)
14 I Transient hotel, motel, 21 I I Parking garage
4 I I Repair, replacement or dormitory — Enter number
5 I I Wrecking (If multifamily residential, of units — --0- 22 I I Service station, repair garage
enter number of units in building in 15 Li Garage 23 r---1 Hospital, institutional
Part D, 13)
16 1 1 Carport 24 L i Office, bank, professional
6 I I Moving (relocation)
7 LL Foundation only 17 I ] Other — Specify 25 I I Public utility
26 Li School, library, other educational
B. OWNERSHIP qt. L_Airijillillil 4-....i 27 n Stores, mercantile
8 Private (individual, corporation,
1 • 28I Tanks, towers
r
nonprofit institution, etc.) - - i/./i,urj 29 Li Other — Specify
A 1 9 Li 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.) f
11. TOTAL COST OF IMPROVEMENT $ <
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 K Masonry (wall bearing) 40 Public or private company Number of stories
31 Wood frame 41 Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 L_I Structural steel dimensions
33 Li 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
51. Enclosed
F. PRINCIPAL TYPE OF HEATING FUEL I. TY 'E OF MECHANICAL
35 r 1 G s Will the - be central air 52. Outdoors
36 il conditioning. L. RESIDENTIAL BUILDINGS ONLY
37 , Electricity 44 pl Yes No 53. Number of bedrooms
38 Coal
39 Other — Specify 6264C, Will there • an elevator', Full
/� 1� 54. Number of
/`�J/rf//J�li�j° \�I/4V'V 46 ` j Yes 47 1 I No bathrooms
Partial
I hereby certify that the.proposed work is authorized by the owner of record
and I have been authorized by the owner to make this application as 'his- -:
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19 .
t, C
DEPARTMENT OF BUILDING INSPECTIONS ,-. DEPT. FILE COPY
212 MAIN STREET D°
NOi M TON, MA. 01060 BUILDING Q° 1,1. 4/fed' / - /9-ild
32 - 109 PER"-'IT VALIDATION
DATE October 14, 19 80 PERMIT NO. 619
APPLICANT Davo Did Tt Sign ADDRESS 78 Cop,
(N0.) (STREET) (CONTR'S LICENSE)
PERMIT TO TnstAl l wood Stine, ( 1 .) STORY For �n d_hurnin
NUMBER OF
Q9 O � stove DWELLING UNITS.
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 78 Conz ZONING
DISTRICT ST
(NO.) (STREET) -
at BETWEEN AND .
,0 (CROSS STREET) (CROSS STREET)
P
n LOT
m SUBDIVISION LOT BLOCK SIZE
t
v
O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
X
B: (TYPE)
B. REMARKS: Install wood-burning stove in existing chimney.
AREA OR
VOLUME ESTIMATED COST $ 15 44 FEEMIT 1Oq
(CUBIC/SQUARE FEET)
OWNER Dave Did It Signs .uI� /� �/
ADDRESS 78 Cons Street, Northampton, Ma. 01060
(Affidavit on reverse side of application to be completed by authorized agent of owner).