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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants r
Name Mailing address — Number, street, city, and Slate ZIP code Tel. No.
Owner or
Lessee 0/0 "/,
Builder's
t.
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
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re wired Check Plan Review Date Plans By Plans B Notes
9 Fee Started y Approved y
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obta ned 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
II. VALIDATION
Building 3/9 FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued l/ 19�_
Building �� /!j � Fire Grading
Permit Fee $ / c�
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile
Plan Review Fee
CITY OF NORTHAMPTON
MASSACHUSETTS
OFFICE of the 1,NSPECTOR of BUILDINGS
Page Plot 2q APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O
p ZONING
I• AT (LOCATION) M /0 D lk DISTRICT
LOCATION (NO.) ,14� (STREET)
OF BETWEEN // -) r AND X�
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
V1
IL TYPE AND COST OF BUILDING — All applicants complete Parts A — D -a
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 netu 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 ❑ Alteration (.See 2 above) Transient hotel, motel, 21 Parking garage
C� ❑
4 L_ 14 T
Repair, replacement or dormitory - Enter number
5 ❑ Wrecking (If multi family 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 26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑❑ Stores, mercantile
8 ❑l Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 Other - Specify
9 D Public (Federal, State, or
local government) Q i t",
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,..,,,•.•......• _� o0 " 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..................... ----°-•— ❑ a:rr,tiLGa---rrJ -'Q- -��ll.
b. Plumbing .................... ---- n
c. Heating, air conditioning..........
d. Other (elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT 1$, c/C"t.
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 exteriors
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?
L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 ❑ Yes 45 No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other - Specify Will there be an elevator? m Full..........
❑ 54. Number of
46 [_1 Yes 47 No bathrooms
- Partial.......
._
4 ,.
Depaaxen;t of Building Inspectiops
BUILDING Z
212 Main Street og glG' D�
Northampton, Ma. 01060 PERMIT 'a
a
35 w 29 VALIDATION
DATE my 90 i9 R2 PERMIT NO. 319
APPLICANT MargaTPt W Tnhin ADDRESS (• gyQ-;+CS
(NO.) (STRE ) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO_�drJi ti nn (�_) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) N0. PROPO D USE
ZONING
AT (LOCATION) an Road DISTRICT
(NO.) ( REET)
BETWEEN 6T nt Farmq Rnafl AND Rftrt¢ Pit Road
(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: Adi tin*+ to existing garage to farilitate working around trucks 9' X 24'
PERMIT
AREA OR ESTIMATED COST $ i0 o on F E 10.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER RM Willard. TnC- BUILD NG PT.
ADDRESS E.n'Box 3OZ�Fln-T-Pne-P. Ma—O10_60 BY
WHITE - FILE COPY GREEN - FIELD COPY • CANARY - APPLICANT C PINK - SORS COPY