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N R rr■ 1:t.NraNNatl 55 05555 �5"=1:999:see 9a:::11,N:" : 9 € :Sg:a15:H195:s15S0 :, _ _ Its gi NOTES and Data — (For department use) r Y IV. IDENTIFICATION — To be completed by all applicants Name Mailing address — Number, street, city, and State ZIP code Tel. No. Owner or Lessee f " Builder's .: 2. i � 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. Signatu of a pli nt� Address Application date �G Y21Z 42 3 00 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Re wired Check Plan Review Date Plans BY Plans B Notes q Fee Started y Approved y BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL Is OTHER Is V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approval Check Obta ned Number By Permit or Approval Check Obta t 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 Building. Use Group Permit issued Fire Grading Building Permit Fee $ f_ �'l Live Loading Certificate of Occupancy $ Occupancy Load Approved by: Drain Tile $ Plan Review Fee TI CITY OF NORTHAMPTON �• MASSACHUSETTS e OFFICE of the INSPECTOR of BUILDINGS .�, Page 2, C_ Plot l6z. � APPLICATION FOR INSPECTOR ZONING PERMIT AND BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O ZONING I• AT (LOCATION) LAC 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 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 12A One family 18 ❑ Amusement, recreational of new bousing units added, if any, 13 Two or more family — Enter 19 Church, other religious in Part D, 13) ❑ Y � ❑ 9� number of units— — — — --> 20❑ Industrial 3 Alteration (See 2 above) 14 ❑ Transient hotel, motel, 21 ❑ Parking garage 4 Repair, replacement or dormitory — Enter number 5 F1 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, 13) 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 B 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 /� ^a processing plant, machine shop, laundry building of hospital, elementary 10. Cost of improvement•y,�ea�(.I;",,, (,! A school, secondary school, college, parochial school, parking garage for, department store, rental office building, office building at industrial plant. To be installed but n:t 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 1$ 0D0i 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................ re 31 gC Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area, � / rn L4 all floors, based on exterior i 32❑ Structural steel dimensions ..................... 33❑ Reinforced concrete H. TYPE OF WATER SUPPLY 34❑ Other — SpeciJy 42 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 Electricity 440 Yes 45 X_ No 53. Number of bedrooms.............. 38 Coo I 39❑ Other — Spat iJy Will there be an elevator? Full.......... 54. Number of 46 � Yes 47 Y I No bathrooms �_' Y1—' Partial....... apartment of Building Inspections .2 Mait: S&e"et BUILDING )rthamp ton, Ma. 01060 0° �a 32C - 145 PERMIT VALIDATION DATE February 1511. 19 83 PERMIT NO. 68 APPLICANT Patil .T_ Rrirt ADDRESS 204 Main S y HaVdonyill_ 002866 (NO.) (STREET) (CONTR'S LICENSE) PERMIT TO Rep r_ n a esidPnli NUMBER OF _—pZ,s4,ta'-j Q 1 C@ (2_) STORY R al DWELLING UNITS 6 _ (TYPE OF IMP//FOVEMENT) NO. (PROPOSED USE) AT (LOCATION) ,L Mi r-ho man AV nue ZONING l B DISTRICT 11Rr (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) 1EMARKS: Repg4ir vACant A Family house, Instal! now xd mdows, Insulate, sheatzock, zepmir siding XU4 and porches, mist. alterations & repairs. REA OR PERMIT OLUME ESTIMATED COST $ '1() 00n FEE $ 120-00 (CUBIC/SQUARE FEET) WNER R- Cchnei dexr R. RE+rgornfl/P_ Rri tt BUILD G D T. DDRESS BY 41L WHITE - FILE COPY GREEN - FIELD COPY ■ CANARY - APPLICANT COPY • PINK - ASSESSORS COPY