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29-281 (2) VIII. ZONING PLAN EXAMINERS NOTES DISTRICT USE FRONT YARD SIDE YARD - SIDE YARD REAR YARD G N_ NOTES r IX. SITE OR PLOT PLAN — For Applicant Use a-S.1 y.� t ...�-� s I t° .,.-.r 1 "�a. "# r "�$ a'a a d#- ..1-t £ 9 f'4 a a-w t�`1 5f at z d ii J=Z 4; & a a 'd r ,. ,�.t t t r -v. 1 * a - Y r a H 4, 9 �� a a i �'t ' ',°'-`-' # # I -.t-� - .a t s.#e1 a L. F J i t Z P C tl if E 9, r g ?S '4 'Y {• .n f 4 r �✓- §"+ 4 It 7 Y 1 1 is+ . t ? € �. } 1� r t a n j e RE-H 1 t� i^ �1 f rr £ r ' i, { w j -'4 +r r -t * ij '4 ` r Y' :'� a.�,. @ :1-4 Ab:.k -� �� p� -y �t§ � t '+ + s..?' f z� � _* � '€ ra- y- •-}'r i - 1 f p w }�-+ ..p <._g,. r i-* w a 48 s a ( a r "3ty a . § A -ra �t7d t a f a a f , 41 e rx E. 41-H- -4 �gje: da .(-�.� £ -S " t '§-a.f '"T' s- a Gaya {gi.. - 9, -t-1 I s � r + gt , r� f'� r� aza {$-d.p� § & -t:1 �° d {r 4 }q-�7J f All Sr'.�P T g-t 5 #-a tt,- a� _ t #¢ i .t"' #. r 'T.9 BOCA FORM APEBP — 669 C1969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC. IV. IDENTIFICATION — To be completed by alP'5Pplicants Name Mailing address — Number, street, city, and State ZIP code Tel. No. Owner or Lessee t 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. Signature of applicant Address Application date f ( 00 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Re wired Check Plan Review Date Plans B Date Plans B Notes 9 Fee Started y Approved y BUILDING PLUMBING MECHANICAL ELECTRICAL OTHER is VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approval Check Date Number B Permit or Approval Ch Date Number B pp Obtained y pp rova Check 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 19 Building Fire Grading Permit Fee $ Live Loading Occupancy Load Certificate of Occupancy Approved by: Drain Tile Plan Review Fee T I T-Lf NOTES and Data — (For department use) r „ .k.. -ftlr 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: I, IA, lll, IV, and IX. O ZONING I• AT (LOCATION) NO T:..T'._-t'j--�-+�-r_-C'L.� DISTRICT y�. LOCATION / REET) OF BETWEEN AND BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE t/1 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 —f 1 New 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 ❑ Industrial 3 F-1 Alteration (See 2 above) 14 l t l t t h i Transenoe , motel,❑ 21 ❑ Parking garage 4 ❑ 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) •_ 6 ❑ Moving (relocation) 16 ❑ Carport 24❑ Office, bank, professional 17 Other - Specify 25 ❑ Public utility 7 ❑ Foundation only 26 ❑ School, library, other educational B. OWNERSHIP 27 ❑ Stores, mercantile ` 28 ❑ Tanks, towers 8 � Private (individual, corporation, Specify Other - S nonprofit institution, etc.) 29 ❑ p fy 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 school, secondary school, college, parochial school, parking garage for, 10. Cost of improvement,,,,,,,,,,,,,,,, �., . Y 9 P P 9 9 9 department store, rental office building, office building of 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. Tl(PE OF SEWAGE DISPOSAL J. DIMENSIONS 30❑ Masonry(wall bearing) 40 Public or private company 48• Number of stories................ 31 fWood 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........................ conditioning? 36,F] oil L. RESIDENTIAL BUILDINGS ONLY 370 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....... 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 BUILDING fa PERMIT VALIDATION DATE ✓77719 PE Np. APPLICANT ' ADDRESS n (N (STREET) CONT R'S L(CENSE) ( / ' NUMBER OF PERMIT TO (�) STORY ✓' '' DWELLING UNITS (TYPE OF IMPROVEMENT) 0. ( 0 SEp USE) �' ZONING — AT (LOCATION) DISTRICT ( O.J (STREET) a BETWEEN AND 'O (CROSS STREET) (CROSS STREET) a_ IL LOT m SUBDIVISION LOT BLOCK SIZE a U O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION O Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION f � .. .... (TYPE) O a REMARKS: 1121 -� VOLUME ESTIMATED COST $ 7 '�i FEE MIT {CUBIC/SQUARE FEET) —7 s� OWNER BUILDING P AODRE BY (Affidavit on reverse side of application to be completed by authorized agent of owner) on will