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IDENTIFICATION — To be completed by all applicants Name Mailing address — Number, street, city, and State ZIP code Tel. No, t. t ,`f Owner or c) � Lessee Ly(q�r,JE: n/ :/� Builder's 7— 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 app 'cant Address Application date 00 NOT WRITE BELOW THIS LINE AN REVIEW RECORD — For office use Plans Review Required Check Plan Review Date Plans B Date Plans B Notes q Fee Started y Approved y BUILDING PLUMBING $ MECHANICAL ELECTRICAL OTHER V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Date Date Permit or Approval Check Obtta 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 ��yy FOR DEPARTMENT USE ONLY _. 01 Permit number 9:' Building Use Group Permit issued _ 19 s Buildin g Fire Grading Permit Fee $ Live Loading Certificate of Occupancy $ } panty Load Approve y: Drain Tile Plan Review Fee TITLE CITY OF NORTHAMPTON �• MASSACHUSETTS OFFICE of the INSPECTOR of BUIL INGS Page4 Plot APPLICATION FOR INSPECTOR ZONING PERMIT AND BUILDING PERMIT z IMPORTANT — Applicant to complete oil items in sections: 1, 11, 111, IV, and IX. O 1• AT (LOCATION �g / L M�Z P-, ZONING j/ •r: / Ofiq,�% � � DISTRICT �`� LOCATION (N 0.) (STREET)/J OF BETWEEN DQ✓/GE Ci��.tN'�tr /`jG AND i�VG�E.SM.Li% BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE 11. TYPE AND COST OF BUILDING — Alf 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 bousing units added, if any, in Part D, 13) 13 Two or more family — Enter 19 Church, other religious 3 Alteration (See 2 above) number of units— — — — ► 20 F] Industrial � _ 14 Transient hotel, motel, 21 Parking garage 4 Repair, replacement or dormitory — Fnter number 5 n_ Wrecking (If multifamily residential, of units ——————— — -- 22 Service station, repair garage enter number of units in building in 15 Garage 23 Hospital, institutional Part D, rel 16 Carport 24 � Office, bank, professional 6 � Moving (relocation) 17 Other — Specify 25 ❑ Public utility 7 Foundation only 26 School, library, other educational B. OWNERSHIP 27 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 1 processing plant, machine shop, laundry building at hospital, elementary 10. Cost of improvement,,•,,,,,,,,,,,,, 4 C U,Q 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 ..................... /1 c. Heating, air conditioning........ d. Other(elevator, etc.)............. 11. TOTAL COST OF IMPROVEMENT $ �Z 0 6 D l 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 t 30 Q 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 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. TYPE OF MECHANICAL 35 Gas Will there be central air 52. Outdoors........................ 36 Oil conditioning° L. RESIDENTIAL BUILDINGS ONLY 37 -� Electricity 44 �,, Yes 45 - No 53. Number of bedrooms.............. 38 Coal 39 j Other — SPccify Will there be on elevators Full.......... 54. Number of 46 Yes 47 ! No bathrooms Partial........ i a DEPT. OF BUILDING INSPECTIONS BUILDING + % 212 Main Street 0 Jt cy: Northampton, MA 01060 PE RMIT 32C - 137 VALIDATION DATE APPLICANT John Fortier ADDRESS 3P-,�R'MIIl�Q 507 P I I (NO.) (STREET) (CONTR'S LICENSEI OF Alteration Off ice Space NUMBERNG UNITS PERMIT TO (-_) STORY (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) 395-403 Pleasant Street ZONING 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 to relocate one non bearing wall and door approx 15' in length AREA OR $ 2,000.00 PERMIT 10.00 VOLUME ESTIMATED COST FEE (CUBIC/SQUARE FEET) OWNER Same as Applicant BUILDING�E�F ADDRESS Same as Applicant's BY 4 0, WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pm IIp