29-303 Grif� of Norf1jamptait
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�-, DEPARTMENT OF BUILDIXG INSPECTIONS
F
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
AS A HOMEOWNER I UNDERSTAND THAT I MAY APPLY FOR AND RECEIVE
A BUILDING PERMIT FOR A HOME OR ADDITION I INTEND TO LIVE IN.
I ALSO UNDERSTAND THAT I AM RESPONSIBLE FOR KNOWING THE STATE
BUILDING CODE AND ZONING ORDINANCE OF THE CITY OF NORTHAMPTON.
BEING A HOMEOWdNER AND NOT A PROFESSIONAL CONTRACTOR IN NO WAY
ABSOLVES ME OF ANY RESPONSIBILITY TO INSURE THAT ALL FACETS
OF THE RULES AND REGULATIONS ARE COMPLIED WITH.
�-VII_I. ZONING PLAN EXAMINERS NOTES
DISTRICT
REAR YARD
IX. SITE OR PLOT PLAN For Applicant Use
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NOTES and Data — (For deportment use)
IV. IDENTIFICATION — To be completed by all applicants f
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
Owner or / % C i Al 101< E tr95
Lessee ,�
v/OFU
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
1-59
E �c SCE S
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Pions Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date D
Permit or Approval Check Obta ned Number By Permit or Approval Check Obtai ote ed 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 - d
Building i(� At� use Group
Permit issued 4`1 I 19
Building Fire Grading
Permit Fee $ ln' Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile
Plan Review Fee
rj` TITLE
CITY OF NORTHAMPTON
g. MASSACHUSETTS
$ f OFFICE of the INSPECTOR of BUILDINGS
,�T Page q=e 6= Plot . APPLICATION FOR
INSPECTOR 1 ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING
I• AT (LOCATION) / ��'l� �[,.> Q/� ✓ DISTRICT
LOCATION (NO.) (STREET)
s1
OF BETWEEN 7 'f/�/ r n. AND 4Lx
BUILDING (C j55 STREET) (CROSS STREET)
� LOT G
SUBDIVISION LOT��BLOCK SIZEOrC•� U,�� S4_
N
I1. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
nn
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 n Two or more family — Frzfer 19 n Church, other religious
number of units— — — — 20 n Industrial
3 Alteration (See 2 above)
14 L_� Transient hotel, motel, 21 Parking garage
4 Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (If multifamily residential, of units ——————— — -i 22 Service station, repair garage
enter number of units in building in 15 Garage 23 Hospital, institutional
['art D, 13) 16 �� Carport 24 Office, bank, professional
6 n Moving (relocation) ��� 25 r1 Public utilit
7 u Foundation only 17 X Other — Specify E I_ _i Y
26 School, library, other educational
B. OWNERSHIP .5TQef 27 i Stores, mercantile
8 X Private (individual, corporation, 28 l Tanks, towers
nonprofit institution, etc.) 29 Other — Specify
9 L_) 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...............• -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
a. Electrical.......................
b. Plumbing .......................
c. Heating, air conditioning..........
d. Other(elevator, etc.)............
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
30 Masonry (wall bearing) 40 �i 1 Public or private company 48. Number of stories................ a.,v
31 ® Wood frome 41 Private (septic tank, etc.) 49. Total square Feet floor area, rear �x
all floors, based on n exterior ' !•tt
32 Structural steel dimensions .....................
33[_j Reinforced concrete H. TYPE OF WATER SUPPLY 1rtT><6, rK
50. Total land area, sq. ft. ...""""
34 l� Other — Specify 42 L_ Public or private company fd
43 F Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed ....................... Ale"AlZ
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 Ei Gas Will there be central air 52. Outdoors........................ v
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 L j Electricity 44 Yes 45 No 53. Number of bedrooms..............
38 Coal
39 Other — Specify All? hf)T Will there be an elevators Full.......... lC V
54. Number of
46 ( Yes 47 X No bathrooms Partial........
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