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NOTES
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BOCA FORM APEBP — 669 C1969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or t�
Lessee F j5 (`ate
Bui Ider'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.
Signat of applicant ^ Address Application date
00 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 Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL Is
OTHER Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or A rovaI Check Date Number By Permit or Approval Check Date Number By
PP Obtained Obtained
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
V11. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number °,•�
Building yc� Use Group
Permit issued 19 ALL
Fire Grading
Building $ �y /zi )
Permit Fee !� / Live Loading
Occupancy Load
Certificate of Occupancy $
Approved by:
Drain Tile $
f
Plan Review Fee
TI LE
NOTES and Data — (For department use)
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 PLAN EXAMINATION AND
3.12 C BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. (J�+ O
ZONING
I• AT (LOCATION) �s �V,Y DISTRICT V
LOCATION r ({N`O.) (STREET)
V
OF BETWEEN `� sz�"i-L C U�_ AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT b S- ,)/, J '
SUBDIVISION LOT BLOCK SIZE
V1
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D M
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
M
1 ❑ New building Residential Nonresidential
2 Addition(If residential, enter number 12❑ One family 18 ❑ Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13❑ Two or more family - Enter 19 ❑ Church, other religious
number of units- - - - --> 20 ❑ Industrial
3 ® Alteration (See 2 above)
14❑ Transient hotel, motel, 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory - Enter number 22 ❑ Service station, repair garage
❑ ------- -
5 Wrecking (If multifamily residential, o units -o.
enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional
Part D, 13) ❑
16 Carport 24❑ Office, bank, professional
6 ❑ Moving (relocation)
17 Other - SpeciJy W fe\1 25 E:] Public utility
7 ❑ Foundation only
\ 26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8 Private (individual, corporation, j1 28 ❑ Tanks, towers
nonprofit institution, etc.) ��` 29 ❑ Other - Specify
9 ❑ Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential - Describe in detail proposed use of buildings, e.g., food
3�Q processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,•,•,,•....... V 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 $ 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
30 Masonry (wall bearing) 40 ❑ Public or private company 48. Number of stories...... area, ...
31 Wood frame 41 ❑ Private (septic tonk, etc.) 49. Total square feet n floor area,
all floors, based on xterior„
32❑ Structural steel �&.e_ dimensions .�' �.,X...�(./�.r...
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34❑ Other - Specify 42 ❑ Public or private company 50. Total land area, sq. ft. ...........
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
NJ .a PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ........................
35❑ Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37❑ Electricity 44❑ Yes 45)Q No 53. Number of bedrooms..............
38 ❑ Coal
39❑ Other - Specify Will there be an elevator? 54. Number of Full..........
46 ❑ Yes 47'X No bathrooms Partial........
S
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tyfi ` "tv ,• "
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hereby certify that the proposed work is authorized by the owner of record
and 1 have been authorized by the owner to make this ctpglication vs lair=
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
..e..>_.... - v
DEPT. FILL %.w,.
DEPARTMENT OF BUILDING INSPECTIONS ZO
212 M 1N STREET O< �!
NOILTWAnONg MA. 41060 BUILDING
PERMIT
VALIDATION
3k - 126 Cade #79
DATE May 9, -19 go PERMIT NO.__ 234
APPLICANT Robert C. ge_kman ADDRESS 36 Fruit
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Stara a shad U—) STORY Wood Storage shed DWELLING UNITS
(TYPE 0 IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) 36 Fr>rlit DISTRICT 11RC
(NO.) (STREET)
rn BETWEEN 0111 $012th AND
T (CROSS STREET) (CROSS STREET)
IL LOT
m SUBDIVISION LOT BLOCK SIZE
a
0 BUILDING IS TO BE 37 FT, WIDE BY 4 FT. LONG BY FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
� (TYPE)
0
IL REMARKS: Rep-laosa Saxa ge- doors-- wood storage sheA- pantm with reef only
AREA OR
VOLUME ESTIMATED COST $ 350.00 FEEMIT $_10.00
(CUBIC/SQUARE FEET)
OWNER _ Robert C. Reek=-R
BUILD G D T.
ADDRESS 36 Fruit Street, Northampton, Ma. 03060 BY
fsffidavit on reverse side of application to be completed by authorized agent of owner)