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NOTES
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
1.
Owner or
Lessee <C cF—
r g may; Builder's
1. �U�f G CE� o+c �=l�t� /�• o 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.
Signature of applicant Address Application date
DO NOT WRITE BELOW THIS LI
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Plans B Notes
q Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obtained Number By Permit or Approval Check Obtained 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 C,I
Building �` p
Permit s use crag
sued 4 s �,' � f q1
Building rN -�
Fire Grading
Permit Fee $ 'L/L Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by: ^
Drain Tile $
M
Plan Review Fee $
TITLE
J &A-40 CITY OF NORTHAMPTON
.g MASSACHUSETTS
$ f OFFICE of the INSPECTOR of BUILDINGS
Page - Plot `S1 APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. / J o
Z ON
I• AT(LOCATI ) r� - ,Itw >� 't D STRI�Ca/,
LOCATION ( )v (STREET)
OF BETWEEN— c� AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
iA
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D —f
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
1 ew building Residential Nonresidential
2 Addition(11 residential, enter number 12❑ One family 18 IX 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- - - - -j► 20 ❑, Industrial
3 Alteration (See 2 above) l
t
l
t
t h
i
ransenoe , motel, 21 Parking garage
❑ C�
4❑ Repair, replacement 14 Tor dormitory - Frtter 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)
7 ❑ Foundation only 17❑ Other - Speci/y 25 ❑ Public utility
26 ❑ School, library, other educational
B. OWNERSHIP 27 L] Stores, mercantile
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
A processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,,,,,,,,,,,,,, q�rW 2 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 uildin is being changed, enter proposed use.
in the above cost f`
a. Electrical....................... Qd'ad
b. Plumbing .....................
c. Heating, air conditioning..........
d. Other(elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $0—d—'
a-44
SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
for wrecking, complete only Part J, for all others skip to 1V.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
30❑ Masonry (wall bearing) 40 [io�j 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
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. ........... i
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 YJ No bathrooms
Partial.......
DEP&W.-QUILDING INSPECTIONS BUILDING z= t gr. DID
212 Main Street 0a
Northampton, MA 01060 PERMIT <a
29 - 152 VALIDATION
t
April 28, 88 251
DATE C PERM17 Iv O.
APPLICANT Lou 1 Ense 1 ek ADDRESS S 0006172
(N0.) (STREET) (CONTR'S LICENSE)
Addition Revolver Club NUMBER OF
PERMIT TO (_) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 579 Ryan Rd. Florence, Northampton evo ver U ZONING
DISTRIC
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: permit for the addition of two rest rooms (one male, one female)
AREA OR 144 sq. ft. ESTIMATED COST $ 9,000.00 FE EMIT 28.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER Northampton Revolver Club /'� "
ADDRESS P.O. Box 26 Florence BYILDI� I¢
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY '• +P'INK - ASSESSORS COPY piNf P