23B-046 (219) For,ALL buildings within Fire District and for other buildings costing $10,000.00 or more, plans
and specifications must be submitted to the Inspector of Buildings for examination and approval.
If building is to be moved give details relative to proposed location as for a new buil h g.
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Application for Permit to Build �l6p i�` '
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I
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. Owners name . z « `... `
2. Owner's address .„..... ........... z ... ....»....„.»....„....„.„............._............._............................„....».......„........................
3. Architect's name ..............„,tf/:Getc« . `...Lc.. ........................ -� ..............................................................................
4. Builder's name .................... 4a `.a�LCs�:......:��'ZC:.E-.._ ...........................................................
5. Builder's address ......................�../ '.z......�,.�C........... ?�; ZZ ..'.... "��......i.. h�C..:: ...................„..........
6. Location of Building. Street No. ........ .. �� {
......................» .............F�s.........». .....: .. ..............»................„...
..
7. Is this a removal or new building `%L�«"" ....„.........................................................._..........................
....................... ............„................... ...
8. If removal, from where ......................„..................................................................„.....................................................................................
9. What is the purpose of building ................./ ....' .....................................................................................................„.................
10. Material of building .................... .............`.aC ................................»....................................................................................
11. If a dwelling, for how many families ........................................„.....Number of rooms ...................................................
12. Is there to be a store in the building A'
13. Size of building, No. of feet front ......7-4).........;No. of feet deep ..... .......; No. of stories .....1...........
14. Size of ell, No. of feet front ........................: No. of feet deep ......: ........; No. of feet high 4,1.„......„........
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 ................1:.......... feet in a....................:�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. Ii at; s m, hot water, fu ce, sto es......................................... Power oil burner ................................................
26. Fireplace ....„............................ 1 .....»».............; Insulation ..............„ / ... ..........................................................................
27. How many sinks ��...;//Toilets ..7._.....; Lavatories ..!..; Bathtubs.'...; Showers... ...; Settubs .0...
28. City Service; Water .......7 ......Sewer ..........ij /.; Road Surface ... 'l.` ; 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. is building will conform to the re uirements of the law.
Signature of applicant ... >....... .... „.. ... ` ......
No.S.2`. .(0......„...........
REMARKS
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