32C-149 (7) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE ��c
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
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 � LZsi o�, / / - �', '7 J r
Lessee
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.
Signature of applicant Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re Plan Review Date Plans B Date Plan
Required Check s
9 Fee Started y Approved By Notes
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or A rovaI Check Date Number B Permit or Approval Check Date Number B
Pp Obtained y PP Obtained 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 I I OTHER
VII. VALIDATION
Building Q FOR DEPARTMENT USE ONLY
Permit number G
Building Use Group
Permit issued 411 lg / 19
Building
T Fire Grading
/ � (:;
Permit Fee Live Loading
Occupancy Load
Certificate of Occupancy
Approved by:
Drain Tile
i
Plan Review Fee
TITLE
NOTES and Data — (For department use)
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET -- l�f/ APPLICATION FOR
NORTHAMPTON, MA. 01060 , PLAN EXAMINATION AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
I. AT (LOCATION) '� �f7 A r¢-T' 1 ��l DISTRICT(�'
LOCATION (N0.) (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 F-1 One family 18 ❑ Amusement, recreational
of new housing units added, if any, 13 Two or more family - Enter 19 ❑ Church, other religious
in Part D, 13) y � g
number of units- - - - -o- 20 ❑ Industrial
3 ❑ Alteration (See 2 above)
14 ❑ 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
Part D, 13) ❑
16 Carport 24❑ Office, bank, professional
6 ❑ Moving (relocation)
17❑ Other - SpeciJy 25 ❑ Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP 27 15;<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 detoil proposed use of buildings, e.g., food
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement................ v 'L 1. 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.......... T-
d. Other (elevator, etc.)............ `
11. TOTAL COST OF IMPROVEMENT $• /l( `
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
for wrecking, complete only Part J, for all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
30�Masonry (wall bearing) 40APublic or private company 48• Number of stories................
31 ❑ Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior 4'
32 ❑ Structural steel dimensions ...
❑ H. TYPE OF WATER SUPPLY ` f
33 Reinforced concrete
34 F-1 Other - Specify 42 ❑ Public or private company 50. Total land area, sq. ft. ...........
43 Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed .......................
35 ❑ Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37❑ Electricity 44 ❑ Yes 45 ❑ No 53. Number of bedrooms..............
38 ❑ Coal
39❑ Other - Specify Will there be an elevator? 54. Number of Full..........
46 ❑ Yes 47 ❑ No bathrooms
Partial.......
I hereby certify that the
propo.5ed work is authorized by the owner of record
and I have been authorized by the owner to make this application as,_jhis -
authorized agent. -
. r� ors,
SIGNATURE OF AGENT `
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
`' r e
DEPART' OF BUILDING INSPECTIONS Z o DEPT. FILE COPY
D-
-- . v�212 MIN STREXT 3J )
Nomme r, MA. mho
PERMIT
VALIDATION
32C — 149
DATE My 219 19 7— PERMIT NO. 218
APPLICANT Clarenee E Deli ale a ADDRESS Edwards -
(NO.) (STRE ) (CONTR'S LICENSE)
OF
Repair re$idenee 1_) STORY Residence DWELLLR
PERMIT TO � ( ING UNITS 12+
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
Q�7
ZONING
AT (LOCATION) 263 287 Pleasant DISTRICT SR
(NO.) (STREET)
a BETWEEN AND
�O (CROSS STREET) (CROSS STREET)
a
LOT
m a SUBDIVISION LOT BLOCK SIZE
a
0 BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
s
O USE GROUP BASEMENT WALLS OR FOUNDATION
Z TO TYPE (TYPE)
f
tr
LL REMARKS: Reglace rear wall & roof of attacahed Storage --
AREA OR ESTIMATED COST $ 2 OOo FEEMIT 10,00
VOLUME
- (CUBIC/SQUARE FEET)
f
OWNER William Nocart y BUILD NG D T
ADDRESS —ELI Rd,9 N'tdkn. - BY
(Affidavit on reverse side of application to be completed by authorize agent of owner)
mill III