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NOTES and Data — (For department use)
q.
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or L'( C��4( It�C;CuE7'!k l I��TS � ( P(lr� t (7 A1Vl 7(Cr�4 1�� } fJ�C)(Ft✓ � G�'1Cz�
Lessee l�
�'` Builder's
2. License No.
Contractor
3. j1fti\ �
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.
SignaR7/7�plantt���''� � Address Application date
/�'�//�/l,S��yAGC, /I�cr�/�Jiu,aTa � /V4,
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL Is
OTHER Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number B Permit or Approval Check Dote Number Obtained y Pp N b By
Y
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
Permit issued lq Use Group�
Building Fire Grading
Permit Fee 0
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved b
Drain Tile $ � ��
Plan Review Fee $
TITLE
t
CITY OF NORTHAMPTON
�. MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
Page 3, �- Plot f 5-Y
APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING /^
I• AT (LOCATION)
4..3 I Y V �-1' 1—�1�. N l-i�-' D I S T R I C T ORCI
LOCATION IRO.) (STREET) �a
OF BETWEEN s lo AND �J )"1`
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
H
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D ;a
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use rn
rn
1 ❑ New building Residential Nonresidential
2,�K Addition(If residential, enter number 12❑ One family 18 ❑ Amusement, recreational
of new housing units added, if any,
in Par[ D, 13) 13 ❑ Two or more fomily - Enter 19 ❑ Church, other religious
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 ❑ Wrecking (If multifamily residential,
of units ------- - -! 22 ❑ Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 �I Hospital, institutional
Part D, 13) 16 Carport
24❑ Office, bank, professional
❑
6 ❑ Moving (relocation) 25 ❑ Public utility
17 � Other - Specify
7 ❑ Foundation only ' 26 ❑ School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8X Private (individual, corporation, 28❑ Tanks, towers
nonprofit institution, etc.) 29❑ Other — Specify
9 D 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 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 s —7
ill. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
for wrecking, complete only Part J, for alt others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
48. Number of stories...............
30 L] Masonry (wall bearing) 40 ❑ Public or private company
41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area,
31 Wood frame p 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. 4t. ..........
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 n Yes 45 No 53. Number of bedrooms..............
38 ❑ Coal
39 Other - Specify Will there be an elevotor? 54. Number of Full..........
46 Yes 47 , No bathrooms
❑ � Partial........
DEPT. OF BUILDING INSPECTIONS BUILDING Z°
212 Main Street 0< /
Northampton, MA 01060 PERMIT
32C - 154 VALIDATION
Albert Touchette DATE May 1 , KiT�VeERMlT NO. 256 Owner
APPLICANT ADDRESS 9 Y
(NO.) (STREET) (CONTR'S LICENSE)
Addition deck NUMBER OF
PERMIT TO (^) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
Kingsley Ave. ZONING 1�
AT (LOCATION) 9 Y DISTRICT ORC
(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 an attached deck
VOLUME ESTIMATED COST $ 700.00 PERMIT 10.00
(CUBIC/SQUARE FEET)
OWNER Same as Applicant
ADDRESS ame as Appl icant I$ BYIL DEP l ls�tn% -
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY P f P