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Ue.' ma • .pu•� Wa uaa�a; e�N,, 1.11 eee1's�t''a ee°� es HH- • •• ....sn ei IN of _ _ ::�as:a::use;�: ��9:4 is :se;:;: mze:;laaa w-_ NOTES and Data — (For department use) IV. IDENTIFICATION - To be completed by all applicants Name Mailing address — Number, street, city, and State ZIP code Tel. No. 1. s o RO MS)"i �.L� 0%0 owner or Lessee Mo, 2 IWI \ Builder's `� License No. Contractor ��.`` �/ /�� p�w`�yr A. 2 3.Architect or Uop, �34 �41�-(AM Sr SPRXN (4 o''05 73 Engineer ('.{ � 1 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. $i nature lI OPII licant Address Application date 1_S(a W I LU ISM Sl-- 5MWOR 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 q Fee Started y Approved y BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL $ OTHER $ V1. 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 Permit issued 19_ff Building Fire Grading Permit Fee $ 7-, Live Loading Certificate of Occupancy $ Occupancy Load Approved by: Drain Tile $ a Plan Review Fee $ �% TITLE CITY OF NORTHAMPTON �• +g MASSACHUSETTS $ f OFFICE of the INSPECTOR of BoUILDINGS Plot Page SJ g APPLICATION FOR ZONING PERMIT AND INSPECTOR BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O �VAQ�5 {1y S� ZONING �- I• AT (LOCATION) �V�.,7V�11� Iti'Li lJ DISTRICT LOCATION r �IN0.) (STREET) OF BETWEEN `✓t`+`"wN AND BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE V1 II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D -i A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use Inn M 1 ❑ New building Residential Nonresidential 2�<Addition(If residential, enter number 12 ❑ One family 18 ❑ Amusement, recreational of new bousing units added, if any, in Part D, 13) 13 ❑ Two or more family — Enter 19 �❑ Church, other religious 3 Alteration (See 2 above) number of units—ransen — — — 20XIndustrial 14 T❑ it hotel, motel, ❑ 21 F:1 garage 4 ❑ Repair, replacement or dormitory — Enter number 5 ❑ Wrecking (If multi family residential, of units ——————— — --30- 22 Service station, repair garage enter number of units in building in 15 ❑❑ Garage 23 L❑ Hospital, institutional P art D, 13) 16 ❑❑ Carport 24 Office, bank, professional 6 ❑ Moving (relocation) 7 �❑ Foundation only 17 ❑� Other — Sped/y 25 ❑ Public utility 26 ❑ School, library, other educational B. OWNERSHIP 27 ❑ Stores, mercantile 8*>ePrivate (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 .�J (��, 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....................... _1144 TLQk� LW U- IN M W %UTZA U 7C COF b. Plumbing ..................... TONE, Mme' F fyizo 1 ES. c. Heating, air conditioning.......... 45 [M d. Other (elevator, etc.)............. 11. TOTAL COST OF IMPROVEMENT III. SELECTED CHARACTERISTICS OF BUIL iNG — 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 �i _ A^ 32— Structural steel dimensions ..................... ��p�f� 33 L❑ Reinforced concrete H. TYPE OF WATER SUPPLY 34 ❑ Other — Specify 42S<Public or private company 50. Total land area, sq. 4t. ........... ©ZQ 43 L Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ....................... 35�_>4Gas Will there be central air 52. Outdoors........................ #z / 36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37 E71 Electricity 44 L F–�J Yes 45 n' No 53. Number of bedrooms.............. 38 ❑ Coal � � tA/,N 39 ❑ Other — Specify Will there be an elevato Full.......... _ 54. Number of 46 Yes 47 No bathrooms Partial....... O � A A a' � � A 'C r► R � Eh • -«, b n O D ° O Q n A � r* ep a c '° - n O eD co CD co y `t7 OQ -5 a C7' _ A c UQ• v'• O, °e rA tz � � b O O �' � p• `d `< A O o �• fD � � eD Z5 M tz a eA o O CA v, cn r CA > 10 M ** � x :� :� �5b � V y H © '� I I �• UQ• WTI 0 �zo O in' A �. O 'r7 if,7 C3. 't3 rA•. �' 7d rA _ o � t.0 y O c rn .H ,S• O 9