29-189 (2) V111. ZONING PLAN EXAMINERS NOTES C�
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
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71
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BOCA FORM APEBP — 669 C1969 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. f'f1•!t/ /' ' , 't /I11" / .r �' ;CC ,/ {^ Ordf sJ+�f r^✓ y^, �l :�
Owner or
Lessee
// Builder's
2. I�e'� .r J�s� �. .�, - ,y> r �-=jl.Y 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 applic Address Application date
D NOT WRITE BELLOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plan Review Date Plans B Date Plans
Plans Review Required Check Fee Started y Approved BY Notes
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
Building �� Use Group
dPermit issue 19�
Fire Grading
Building O C
Permit Fee . �—" __._ Live Loading
Occupancy Load
Certificate of Occupancy
Approved by:
Drain Tile
Plan Review Fee
__DTI
1
NOTES and Data — (For department use)
CITY OF NORTHAMPTON f , {
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 PLAN EXAMINATION AND
BUILDING PERMIT
IMPORJTjA�N�T% — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. I o
ZONING
I• AT (LOCATION) / /b+� � �.�f'r�Li IL�M� DIISTR CT! ,
LOCATION (STREET) ,,pf�
OF BETWEEN � i� P c°t?'er � r/�'�= AND �'r[�f���:��'i /• l'�;�E.$'._. (' F
BUILDING (CR�SS STREET) (CRaSS;S'i EFT)
LOT
SUBDIVISION LOT BLOCK SIZE
II. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — DN-I
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
M
i ❑ w building Residential Nonresidential
2 Addition(If residential, enter number 12 ❑ One 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- - - - -� 20 E:] Industrial
3 F-1 Alteration (See 2 above) 14 ❑ Transient hotel, motel,
21 El Parking garage
4 F—] Repair, replacement or dormitory - Enter number
5 ❑ Wrecking (If multifamily residential, units ------- - � 22 ❑ Service station, repair garage
enter number of units in building in 15 Garage 23 ❑ Hospital, institutional
Part D, 13) 16 ❑ Carport 24 E] Office, bank, professional
6 ❑ Moving (relocation) p
17 ❑ Other - Specify 1 �'+. ✓�_ 25 ❑ Public utility
7 F-1 Foundation only t 26 ❑ School, library, other educational
B. OWNE 28 Tanks, towers SHIP �r 27 ❑ Stores, mercantile
❑8 Private (individual, corporation, �'
nonprofit institution, etc.) ��,�� r 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•,,,••,•,••••••• G3i'l 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..................... j
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 g
30❑ Oasonry (wall bearing) 40 ❑ Public or private company 48• Number of stories............... /
31 od 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
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ......... ......
35 ❑ Gas Will there be central air 52. Outdoors........................
36 Oil conditioning?
RESIDENTIAL BUILDINGS ONLY
37 F-] Electricity 44❑ Yes 45 � L.No 53. Number of bedrooms..............
38 ❑ Coal
39 Other - Specify Will there be an elevator? Full..........
54. Number of
46 ❑ Yes 47 E?�'Na 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 his
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
DEPT. FILE COPY
ZO
DEPT. OF BUILDING INSPECTIONS BUILDING
212 Main Street PERMIT VALIDATION
Northampton,Mass.01080 29 - 189
DATE October 20, 19?8 ._ PERMIT NO. 494
APPLICANT Lenin PP r177.nV __ ADDRESS 148 rfi d L
Dry 'ton.
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO 2 Car C=a aOP. NUMBER OF
'�' (`) STORY C=arage DWELLING UNITS
(TYPE AF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) 148 Deerfleld Drive DISTRICT USA
(NO.) (STREET)
w BETWEEN QjTarl nnk T)ri 3zp AND Rrnnkgi dP Circle
'a (CROSS STREET) (CROSS STREET)
w
LOT
IL SUBDIVISION LOT BLOCK SIZE
m
a
V
O BUILDING IS TO BE 18 FT. WIDE BY 25 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
M
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: Construct 2-car attached garage
AREA OR 1, PERMIT
.
�
VOLUME x+32 _ — ESTIMATED COST $ 4 FEE ��_OO
(CUBIC/SQUARE FEET)
OWNER T nnn Padr11onu
,I BUIL
ADDRESS 148 Deerfield d Drive N'ton. , Ma. BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)