29-403 (5) For ALL buildings within Fire District and for other buildings costing$10,000.00 or more, plans
and specifications must be submitted to the tnapector of Buildings for examination and approval.
If building is to be moved give details relative to proposed location as for a new building.
0y _ a
Application for Permit to Build r
Northampton, Mass., ....... ?.« ....«. :.........19. .
To the Inspector of Buildings:-
The undersigned hereby applies for a permit to build, move, alter, or repair, according to the
following specifications.-
1. Owner's name ) -~ � r..«.. .................
. ............«.......».......»........
2. Owner's address «C �.j.:..` .......«........
3. Architects «.... ........ �,� ....«......... «
tect's name f�..1.i. � f i `'" ..:`" :5..!..5::.%?.LZ............... ....«. .. ....... .... ...... .........................
4. Builder's name f F t {
5. Builder's address .....« .' r �> v 7 «............ i. »................«.....»........
....... y `.. " 7 .«..............
6. Location of Building. Street No. - :�! �L.��.. ...f... � ...»..f.
7. Is this a removal or new building............. . . . . ... ......«..........«...............................«........................................
8. If removal, from where «............«..........«............«...........................................
9. What is the purpose of building ............. ................ ... .. .. ..r� `.......................................
:.
10. Material of building .............1: .:F: :S. ..«........ ............»............................«.........................................
11. If a dwelling, for how many families .....«...1...........................».....Number of rooms ...................................................
12. Is there to be a store in the building .....»....».......................................................................:.......«...........................................
13. Size of building, No. of feet front .....»....»...........;No. of feet deep ......................; No. of stories ...................
14. Size of ell, No. of feet front ........................: No. of feet deep ...........»»......... No. of feet high ...........»............
15. Size of Lot .....«........................................................................Feet Wide ...............................«.. Feet Deep .................................
16. How near the-line of street ..............................................................................................................................................................
17. How near the line adjoining lot. Right..................................; Left...................................; Rear
18. Nearest building is ................................feet in a..................................................... direction ......................................................
19. Material of the floor ..........................................................................................................................................................................
20. Size of timbers, 1st ...........»....»....; 2nd .....»....«....«.... ; 3rd .......................: 4th ............................; 5th ............................
21. No. of feet span...........».............».....................«................... ; Distance on centers .....»............................«..............................«..
22. Will the building be erected on solid or filled land .....«...............«............ ........»........................................».............
23. What is the material of foundation .....»....».«....».............«....«.......»....»....»..................«.............; Footing .......................
24. Will the roof be flat or pitched ...........».»....»............................»....».....; Covering....................».
25. Heat; steam,,hot twwater, furnace, stoves ».......................................; Power oil burner ..............................................
26. Fireplace ..,..`......................»..........»......................; Insulation ..............»...............................................................................................
27. How many sinks ............: Toilets ...........; Lavatories ........; Bathtubs.....»..; Showers............; Settubs .........
28. City Service; Water ....................... Sewer .......................; Road Surface .........................; Sidewalk .................».....
29. Is lot on accepted street ........«....«....«.»..........»..«...»......»....«..................«..........«.....................................»....«.................«....................
30. Estimated cost (must be filled out) ........ . .....................................«....«.......»................«....«........
Applicant agrees to give the Inspector of Buildings 24 hours' notice before lathing or
plastering this building. This building will conform to the requirements of the law.
Signatureof applicant ,:...» ...h.«/ » ..«.........................»......................................
No.... .. ........»...........
REMARKS
.711"r/'....................... , .........1. t?� .. �.i a........ ....«�,X »1� ......«......................... ... :».
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..M. ..t.:. G..��..:..Y`::G. ».....L.t«....... .R...».»............................».......................................................................................................j........�............
«.«.......»...........«...........................«..........«.......».......».............«.«....».».......»..............................................................................................................................................
I hereby certify that the proposer{ wor1/Peauthori zed- y-the mmer.df record
and 1 have been authorized by the ownir'-f6"make..thist'*prl% atian as Otis _
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
/ — DEPT. PILE COPY
ZQ
City of Northampton BUILDING <a -
MaRsachusetts PERMIT
Office of the Inspector of Buildings VALIDATION
DATE G..Q 19.7(a ERIAIT NO.
APPLICANT ` ADDRESS
(NO.) (S EET) (CONTR'S LICENSE)
NUMBER OF /
PERMIT TO (_) STORY DWELLING UNITS [
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) DISTRICT
(NO.) (STREET)
rn BETWEEN AND
'o (CROSS STREET) (CROSS STREET)
O�
LOT
D SUBDIVISION LOT BLOCK SIZE
m
a
U
O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
2 s (TYPE)
Ir
IL REMARKS:
AREA OR !�fZ G V PERMIT $ /C},00
VOLUME ESTIMATED COST FEE L
(CUBIC/SQUARE FEET)
OWNER BUILD D
ADDRESS BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)