32C-293 VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
A
USE --7
—:2
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 & tODE DMIN ZSRA�6RS
A INTERNATIONAL j
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or 1 & l
Lessee '
_ Builder's
C l ( ) "fit License No.
Contractor
l G4
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-13f applic 'rtt Address Application date
f
„J DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING
MECHANICAL
ELECTRICAL
OTHER
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Obtained Number By Permit or Approval Check Obtained
BOILER 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
VII. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number —Tc �
Building ( Use Group
Permit issued Zs,27 '�_ 19
Building Fire Grading
Permit Fee Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile
Plan Review Fee
TITL
d
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
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
1. ZONING
AT (LOCATION) = _ DISTRICTL-ice^.
LOCATION (NO.) (STREE
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
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
mss- ' ..,�
M
Residential Nonresidential
2 ❑ Addition(If residential, enter number 1?rT!q.Dne family 18 ❑ 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-- — — — -q. 20 Industrial
3 ❑ Alteration (See 2 above) 14 E:] Transient hotel, motel, ❑
21 ❑ Parking garage
4 E:] Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (If 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 24❑ Office, bank, professional
6 ❑ Moving (relocation)
17 Other — Specify 25 ❑ Public utility
7 ❑ Foundation only 'y 26 ❑ School, library, other educational
B. 0 RSH I P .�'.t�-t-P 1t+pI r 27 ❑ Stores, mercantile
i
8 Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 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.)............ �f
11. TOTAL COST OF IMPROVEMENT $ 000
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 ❑ Public 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
3�'Z Structural steel dimensions .....................
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34❑ Other — SpeciJy 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❑ Electricity 44 ❑ Yes 45 ❑ No 53. Number of bedrooms..............
38 ❑ Coal
39❑ Other — Specify Will there be an elevator? Full..........
54. Number of
46❑ Yes 47❑ No bathrooms
Partial.......
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 his
authorized agent.
SIGNATURE OF AGENT
7
ADDRESS
(NUMBER) (STREET) (CITY-)
APPROVED BY TITLE
DATE 19
DEPT. FILE COPY
zo
CITY OF NORTHAMPTON BUILDING <a
NORTHAMPTON, MA. 01060 32C-293 PERMIT VALIDATION
DATE june 14, ig. 78 PERMIT NO. 228
APPLICANT Robert Wager ADDRESS 20 Valley
(NO.) IS T R EET7 (CONTR'S LICENSE)
NUMBER OF
PERMIT TO I.-gromd pool (_) STORY Swimm-il Pool DWELLING UNITS
PROPOSED U
(TYPE OF IMPROVEMENT) NO. ( SE)
ZONING
AT (LOCATION) _ 20 Valley DISTRICT j C
(NO.) (STREET)
a BETWEEN AND (
(CROSS STREET) ceo55 STREET)
LOT
IL SUBDIVISION LOT BLOCK SIZE
a
V
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
� (TYPE)
K
o REMARKS: Tn-,ta11 16 X 28' i T1 ground sw i n - n�nool ---
AREA VOLUME ESTIMATED COST $_2.000 FEEMIT w 10.00
(CUBIC/SQUARE FEET) ,P
OWNER Robert & Margaret WArer --- �
BUI ING P .
ADDRESS 20 Val�P- S't'rew t'-N/-t nn BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)