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NOTES and Data — (For department use) IV. IDENTIFICATION — To be completed by all applicants Name Mailing address — Number, street, city, anti State ZIP code TiP .;No. Owner or Lessee Builder's l 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 r 00 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Required Check Plan Review Date Plans B Date Plans By Notes y Fee Started Approved BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL $ OTHER $ VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Date Date Permit or Approval Check Obta ned Number By Permit or Approval Check Obtai 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 V11. VALIDATION Building R, r1l FOR DEPARTMENT USE ONLY Permit number But Iding. p Use Group Permit issued _ 19 Building Fire Grading Permit Fee $ Live Loading Certificate of Occupancy $ Occupancy Load Approved by: Drain Tile $ Plan Review Fee $ ITL CITY OF NORTHAMPTON # +� MASSACHUSETTS OFFICE of the INSPECTOR of BUILDINGS "t Page ;5? Plot APPLICATION FOR INSPECTOR ZONING PERMIT AND BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O I• ZONING AT (LOCATION) j_ / •"�' / ^-'<" l 1 DISTRIC T LOCATION (N0.) (STREET) OF BETWEEN AND BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE Vr II. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m M 1 ❑ New building ReLsidential Nonresidential 2 Addition(1 residential, enter number f 12 tKOne family 18 ❑ Amusement, recreational of new housing units added, if any, in Part D, 13) 3 ❑� Two or more family — Enter 19 ❑ Church, other religious 3ZAlteration (See 2 above) number of units— — — — 20 ❑ Industrial 14 ❑ Transient hotel, motel, 21 ❑ Parking garage 4 ❑ Repair, replacement or dormitory — Enter number 5 ❑ Wrecking (1f 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 ort 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 `l. / ❑ nonprofit institution, etc.) ��/ �G'�t V �` J ❑ 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 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.)............. �y 11. TOTAL COST OF IMPROVEMENT Is , (f III. SELECTED CHARACTERISTICS OF 91.110DING, — 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.....❑ ....... 31 Z Wood frame 41 ❑ Private (septic tank, etc.) 49• Total square feet of floor area, all floors, based on exterior ❑ 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 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 7j Electricity 44 ❑ Yes 457� No '- 53. Number of bedrooms... ....... ❑ Coal 39 ❑ Other — Specify Will there be an elevator? Full... 54. Number of 46 ❑ Yes 47 No bathrooms partial.,..... .�.� Y �� , ` � � , �. DEPARTMENT OF BUILDING INSPECTIONS 212 MAIN STREET BUILDING a d, 7/1Yl' NORTHAMPTON, MA. 01060 PERMIT a 29 - 379 VALIDATION DATE_�7 y�19_81 PERMIT NO. 417 APPLICANT Jose' 0. avers v��ti Boil ADDRESS � 11_Flc�reacp Ed- (N0.1 (STREET) (CONT R'S LICENSE) NUMBER OF PERMIT TO (_�) STORY Npn[1 & coat buffing DWELLING UNITS 1 'E F IMPROVEMENT) N0. (PROPOSED USED ZONING tTpA AT (LOCATION) 761 Florence RoAd 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: Fxtptic�r maannary chimney & install wood/coal bL+"*+in$ stove is cellar AREA OR PERMIT VOLUME ESTIMATED COST FEE (CUBIC/SQUARE FEET) OWNER Tnntul 1)r Anti BUILDING PT. ADDRESS 761 F1 nTPn 01060 BY WHITE - FILE COPY . GREEN - FIELD COPY CANARY - APPLICANT COPY - ASSESSORS COPY