32C-237 2
VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT Z C
USE 3
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
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BOCA FORM APEBP — 669 01969 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.
1.
Owner or
Lessee
Builder's
2. License No.
Contractor L
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
e this application as hi authorized agent and we agree to conform to all applicable laws of this jurisdiction.
ignaT re of ap icant Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Rate Plaate Plan
Plans Review Required Check PlanFeeview DStarttedns By DApproveds By Notes
BUILDING $
PLUMBING $
MECHANICAL
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number B Permit or Approval Check Date Number By
pP Obtained y Pp Obtained
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 22
Building Use Group
Permit issued ���_Q� `3l)/ 193'
Fire Grading
Building
Permit Fee $ 7= 6>o Live Loading
Occupancy Load
Certificate of Occupancy
Approved by:
Drain Tile $
Plan Review Fee $
TI LE
NOTES and Data — (For department use)
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 PLAN EXAMINATION AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING
I• AT (LOCATION) 1r ,22 DISTRICT
LOCATION (NO,) r (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
-4
1 ❑ New building Residential Nonresidential
2 Addition(1 residential, enter number
J 12 E] One family 18 E] Amusement, recreational
of new housing units added, if any, 13XTwo or more family - Enter 19 ❑ Church, other religious
in Part D, 13) number of units- - - -
20 ❑ Industrial
3 ❑ Alteration (See 2 above)
14 Transient hotel, motel,
21 ❑ Parking garage
4,X o Repair, replacement or dormitory - Enter number
� 22 ❑ Service station, repair garage
5 ❑ Wrecking (If multifamily residential, J units ------- - -
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 Qtr' 27 ❑ Stores, mercantile
8Z Private (individual, corporation, it 28 ❑ Tanks, Towers
nonprofit institution, etc.) �] `vim ® 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................ $ IV, 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 1$ Dl�
III. SELECTED CHARACTERISTICS OF WILDING — 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 Wood frame 411 Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior
32❑ Structural steel dimensions .......
33 ❑ Reinforced concrete H. T P OF WATER SUPPLY G /
34 ❑ Other - Specify 42Public or private company 50. Total land area, sq. ft. ...........
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........................
conditioning?
36 F-1 oil \/ L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44❑ Yes 45 Na 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other - Specify Will there be an elevator? Full..........
54. Number of
46 E] Yes 47 No bathrooms Partial........
1 ,hereby certify that the proposed work is authorized by the owner 'of' recdrd
and I have ,been authorized by the owner to make this application as ;,his
authorized agent.
a
SIGNATURE Ole'AGENT
ADDRESS r_
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 1g
a
DEPT. FILE COPY
O
DEPARTNUT OF BUILDING INSPECTIONS D-
212 MAIN STREET BUILDING a a
NOATHMTONV MA. 01060 PERMIT
VALIDATION
32C • 237
DATE —13,330 30- 19 80 PERMIT NO. 330
APPLICANT M rhaet Cerra ADDRESS 19 R_ Ballard St.. BBgthm.
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO ( 2 STORY pare-has DWELLING UNITS 3
(TYPE F IMPROVEMENT) NO. (PROPOSED USE)
�'�7f ZONING
AT (LOCATION) 12 Ra:Rto AY/PfiL@ - DISTRICT URC
(NO.) (STREET)
a BETWEEN AND
.o (CROSS STREET) (CROSS STREET)
a
LOT
o SUBDIVISION LOT BLOCK SIZE
m
a
U BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
M
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
O
IL REMARKS:
PERMIT d,
AREA OR VOLUME ESTIMATED COST $ 9*000 FEE 27 00
•
(CUBIC/SQUARE FEET)
t
OWNER BUILD G PT.
ADDRESS ,A7 Fante= Lve Y N�tOYt� - BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)