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DISTRICT
/`.
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
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NOTES and Data — (For department use)
IV. IDENTIFICATION - To be completed by all applicants '
Name Mailing address - Number, stmt, city, and State ZIP code Tel. No.
-T-A r-,/ �391[�QS��ae.�r/1D�II►L �� �r a.►YIpfO�t.t 444- 01040 694-1810
Owner or
Lessee l�aerba��q Fl. tae S39eJ�5-Fw�pfo►� � .C�ar'f!`e�ryp�aw A'(0. olotto Ssab-18
2. FIOrCrlte Sca)►►w��K N�q�a` S� d P.K J(IIe Liicens errNo. Z`S-3G
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.
Si n re of applicant Address Application date
W o.S f-ko-W.,p`k�•�. 13d� A- -1-4 . Q 40.1 /Z 3 I89
rtcti
D0 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans
Fee Started y Approved By Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL Is
OTHER Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number By or Permit Approval Check Date Number B
Obtained 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 OTHER
VII. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Bui Iding
Use Group
Permit issued " ' �� � � 19
Building Fire Grading
Permit Fee $ Live Loading
Certificate of Occupancy $ Occupancy Load
proved by:
Drain Tile $
Plan Review Fee $ j
LE
CITY OF NORTHAMPTON
�. .e MASSACHUSETTS
r •
$ OFFICE of the INSPECTOR of BU LDINGS
Page
Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING
(• AT (LOCATION)
53 4-o k, RA DIISTR CT .
LOCATION t–� (NO.) (STREET)
OF BETWEEN H'.Ce. AND G
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D ;0
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use M
m
1 ❑ New building Residential Nonresidential
2 ❑ Addition(If residential, enter number 12 rV1 One family 18 ❑ Amusement, recreational
of new housing units added, if any, 13 Two or more family – Enter 19 ❑ Church, other religious
in Part D, 13)
number of unzts– – – – --)� 20❑ Industrial
3 Alteration (See 2 above)
14 ❑ Transient hotel, motel, 21 El Parking garage
4 LNepcir, replacement or dormitory – Enter number
5 ❑ Wrecking (If multifamily residential, of units ––––––– – --- 22 L� Service station, repair garage
enter number of units in building in 15 ❑� Garage 23 l❑ Hospital, institutional
Part D, 13) 16 �❑ p Car ort 24 Office, bank, professional
6 Moving (relocation)
❑ 17 ❑ Other – Speci/y 25 Public utility
7 ❑� Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8 ❑ Private (individual, corporation, 28 Tanks, towers ^�Q
nonprofit institution, etc.) 29 Other – Specify
9 ❑ Public (Federal, State, or CIL3 GCOUNA)
local government)
C. COST (Omit cents) Nonresidential – Describe in detail proposed use of buildings, e.g., food
O processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,,,,,,,,,•.... �� Qi 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 Z -tom C c —7
a. Electrical....................... l g f X 37 t rw � 5
` U
vw-d co Mk Y60
b. Plumbing ....................... p n
•t8 r "��'I V c.�..'t-G V S e O t• Oca��cr'
c. Heating, air conditioning..........
54eel UJOLl1S W/ E)I&q t /..I n..Gr'
d. Other (elevator, etc.).............
O6
11. TOTAL COST OF IMPROVEMENT $ 6
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
48. Number of stories................
30 ❑ Masonry (wall bearing) 40 ❑ Public or private company
31 ❑ Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area, �q
all floors, based on exterior �(�2 °1^
32 ❑ Structural steel dimensions ..................... J
33 E] Reinforced concrete H. TYPE OF WATER SUPPLY
34 Other 42 ❑ Public or private company 50. Total land area, sq. 4t. ..........
❑ – Specify
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........................
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 elevotorl 54. Number ull..........
ber of
46 C_� Yes 47 !J No bathrooms Partial........
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