32C-248 VIII. ZONING PLAN EXAMINERS NOTES
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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. CLn6Z!) -Z
Owner or
Lessee
Builder'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.
Signatur of applicant 1 Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re wired Check Plan Review Date Plans By Plans B Notes
q Fee Started y Approved y
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or A rova I Check Date Number B Permit or Approval I 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 OTHER
VII. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued ���-7 19�c'�
Building
r' Fire Grading
�
Permit Fee $ Live Loading
Occupancy Load
Certificate of Occupancy
Approved by:
Drain Tile
Plan Review Fee f f°
i TIT
NOTES and Data — (For department use)
T> cp,73E
L y
e
CITY OF NORTHAMPTON Nct Z.C z L
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. 11 O
ZONING
D STR CTS./
I• AT (LOCATION) 'I— ,� C � �
LOCATION N0.) 'I (STREET) T I �/F--^� `
OF BETWEEN 7— AND CA I-W ,k!! \
BUILDING (CROSS STREET CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vr
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 Re *d ntial Nonresidential
2 ❑ Addition(If residential, enter number 12 jne family IS ❑ Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 ❑ Two or more family — 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 ——————— — -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) 25❑ Public utility
17❑ Other — Specify
7 ❑ Foundation only
VV
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
6 �rivate (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 ❑ Other — Specify J
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.).............
11. TOTAL COST OF IMPROVEMENT $
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) 40�ublic 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
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. 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........................
�y conditioning?
36 I,�.ytil 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 XNo bathrooms Partial........
I hereby certify that the proposed work is authorized by the owner of record
and I have been authorized by the owner to make this application-'.as hi,s
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE }g
zD
DEPT. FILE COPY
.� CITY OF NORTHANPTON BUILDING
PERMIT VALIDATION
NORTHAMPTON, MA. 32C - 248
DATE .T121yv ?-o— -- 19 7P PERMIT NO. 307
APPLICANT cam M ark ADDRESS
(NO.) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Alter Residence __ (�) STORY Rpsi denee DWELLING UNITS �
(TYPE OF IMPROVEMENT) NO, (PROPOSED USE)
ZONING
AT (LOCATION) 3E?HQ3yoke St. - DISTRICT ZTR(.'
(N0.) (STREET)
i v
rA BETWEEN _ Hawley AND Will i aT"e
b (CROSS STREET) (CROSS STREET)
a
LOT
iL 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)
0:
REMARKS; Remodel kitehan bathroom & new bay wii-idp * -
AREA OR ESTIMATED COST $ 3.000 FEEMIT 10.00
VOLUME
(CUBIC/SQUARE FEET)
f
OWNER X 7,ad o3m T -- BUIL I
ADDRESS 36 Holyoke Street NI-ton.- BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)