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N ...f1/. ■... \.a.. NOTES and Data — (For department use) IV. IDENTIFICATION — To be completed by all applicants Name Mailing address — Number, street, city, and State ZIP code Tel. No. Owner or Lessee �W(�G Builder'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. Signature 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 B Date Plans B Notes 9 Fee Started y Approved y BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL Is OTHER is VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approval Check Obta t ed Number By Permit or Approval Check Obtained Date 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 Bui Iding Use Group Permit issued !� 19 � Building Fire Grading Permit Fee $ Q Live Loading Certificate of Occupancy $ Occupancy Load pr ve by: Drain Tile $ Plan Review Fee $ TITLE CITY OF NORTHAMPTON �• �:� MASSACHUSETTS $ OFFICE of the INSPECTOR of BUILDINGS Page 30 C Plot 13-3 APPLICATION FOR INSPECTOR 20NING PERMIT AND BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O ZONING I• AT (LOCATION) DISTRICT LOCATION IN 0.)' (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 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, 4 Repair, replacement 21 C� Parking garage p p or dormitory - Enter number r 5 ❑ Wrecking (11 multi family residential, of units ------- - -i 22 L� Service station, repair garage 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 - Speci/y 25 ❑ Public utility 7 ❑ Foundation only 26 ❑ School, library, other educational B. OWNERSHIP 27 IVI Stores, mercantile 8 Private (individual, corporation, 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 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 'sting building is being changed, enter proposed use. a.a. the above cost A� Electrical..................... b. Plumbing ..................... c. Heating, air conditioning.......... d. Other (elevator, etc.)............. 11. TOTAL COST OF IMPROVEMENT is �9) 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 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY 34 ❑ Other - Specify 42 F-] Public or private company 50. Total land area, sq. ft. .......... 43 ❑ 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 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37 C) Electricity 44 [-_-] Y es 45 N o _-. 53. Number of bedrooms.............. 38 ❑ Coal 39 ❑ Other - Specify Will there be an elevators Full.......... - 54. Number of 46 ( Yes 47 i❑ No bathrooms Partial........ DEPT. OF BUILDING INSPECTIONS BUILDING ZO 212 Main Street '< Northampton, MA 01060 PERMIT <a e 32C - 133 VALIDATION DATE November 20, 19 86 PERMIT NO. 685 APPLICANT Jack Fortier ADDRESS 70. Box 376, Florence Owner (NO.) (STREET) (CONTR•S LICENSE) PERMIT TO Alterations (�) STORY Stores/Mercantile _NUM ER OF DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) 59 Service Center Road ZONING xlsx SI AT (LOCATION) DISTRICT (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: permit for the installation of new partitions for retail use/Per ZBA Approval AREA OR PERMIT VOLUME ESTIMATED COST $ 500.00 FEE s 10.00 ICUSIC/SOUARE FEET) OWNER Saw AC Anrl iral]t �a ADDRESS Sam e a-q A661 ira I C BY ILDt �BE WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY • PINK - ASSESSORS COPY POP