35-062 (3) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
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 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.
Owner or ',ejfJ'1:-L l�CCi't'✓" t-.�5.1_. i�4` i y�;.r ��L' - _ J 1.rC'(, G �i
Lessee
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.
S+gnaturer`o{Tapp4cont Address r� > Application date
00 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 A rovaI Check Date Number B Permit or Approval Check Date Number B
PP Obtained y PP 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 I I OTHER
VII. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building �j�j Use Group
Permit issued 19` 7
Fire Grading
Building ! O Qo
Permit Fee Live Loading
Occupancy Load
Certificate of Occupancy
*d by:
Drain Tile
Plan Review Fee
TITLE
NOTES and Data — (For department use)
4A-Vb
t:7 ( r s
u
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 ��� `Z PLAN EXAMINATION AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
,+ , f ZONING
I• AT (LOCATION),�l , ?34' f •,) V I DISTRICts _
LOCATION ("O•) (STREET) j /1 �1
OF BETWEEN 7^}fa AND faYA
BUILDING (CROSS STREET) (CROSS STREET)
LOT , c /
SUBDIVISION LOT BLOCK SIZE i
V1
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
M
ti'�New building Resid tial 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 X Alteration (See 2 above)
14 ❑ Transient hotel, 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) ❑
16 Carport 24❑ Office, bank, professional
6 ❑ Moving (relocation)
17 F-1 Other — Specify 25 ❑ Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ 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
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.)............
11. TOTAL COST OF IMPROVEMENT I$,,-
Ill. 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
32 Structural steel dimensions .....................
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY Q
34 ❑ Other — Specify 42 ❑ Public or private company 50. Total land area, sq. ft. ...........
43 F-1 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 NNo 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevator? 54. Number of Full..........
46 ❑ Yes 47 No bathrooms
Partial.......
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hereby certify that the proposed work is authorized by the`6wner of record
and i have been authorized by the owner to make this application as his
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) , . ,jC1TY)
APPROVED BY TITLE
DATE 19 .
e. Q., 1:.0
DEPT. FILE COPY
2 OF BUIWIN INSPECTIONS O a
BUILDING
NoRTHA>mN. ran. m6o PERMIT
VALIDATION
35 - 62
DATE r�9g 19 PERMIT NO. 116
APPLICANT Daniel E. Breen ADDRESS 1, 7 BWU Pit Rd.
(NO.) (STREET) (CONTR'S.LICENSE)
NUMBER OF
PERMIT TO .Addition & altera. STORY Re9i.dential garage DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) 13$7 Butte Pit Rd. DISTRICT SR
(NO.) (STREET)
a BETWEEN RxIm AND p.,,�a
(CROSS STREET) (CROSS STREET) .
LOT
d SUBDIVISION LOT BLOCK SIZE
m p JvvF44w IS TO BE 28
FT. WIDE BY 24 FT. LONG BY FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
M
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
f (TYPE)
CK
u- REMARKS: Al to re.'t inn & addition to garAOe
AREA OR i
VOLUME 672 ESTIMATED COST $ PERMIT o 0
(CUBIC/SQUARE FEET)
OWNER 'nan Irel R, R2+een
�Qr� B P
ADDRESS 1; 77-Ea3Yte pl-t Rd � NIton-
(Affidavit on reverse side of application to be completed by authorized agent of owner)
no oil