36-006 (3) .7
For ALL buildings within Fire District and for other buildings costing $10,000.00 or more, plans
and specifications must be submitted to the Inspector of Buildings for examination and approval.
If building is to be moved give details relative to proposed location as for a new building.
Application for Permit to Build
Northampton, Mass., ......,;1.c: . /..e....2..7...19... .1
To the Inspector of Buildings:-
The undersigned hereby applies for a permit to build, move, alter, or repair, according to the
following specifications.-
1. Owner's name �C??x&S..........:..<.:...... 17�hkla._V.
2. Owner's address ........_....P-2...... 1 .Z`'...........1 r..._.........��,2,V_c......................................._..........................
3. Architect's name . ............./•,1..,1,1...... .. ..� ,/7.Lt.,C� ......... ',L'^ '.. :.C. ..........................................................
4. Builder's name ....................» ........._............................_.............................................................................
5. Builder's address ............................................_.............................._....................................................................................................................
6. Location of Building. Street No. ..............................,........._............................_........................................................................
7. Is this a removal or new building.............�,r r.'............... . .. �I f U��l.. ........................... ....................
8. If removal, from where .......................................................................,.... ..,........_.................................................................._.................
9. What is the purpose of building ............ rof f.e...............................................................................................................
10. Material of building ................... ano-d..................................................._..........................................._.........................................
11. If a dwelling, for how many families .......... .............................Number of rooms ...................................................
12. Is there to be a store in the building ........ ..................................................j.............:........................................................
13. Size of building, No. of feet front .....A01:7.....;No. of feet deep .. L,C...._.....; No. of stories ..........._.... ..
14. Size of ell, No. of feet front ........"r-.....; No. of feet deep ........................: No. of feet high ...........»............
15. Size of Lot ........,01-11t.t.... ?/k.4.-4......................Feet Wide ......... ............ Feet Deep .................................
16. How near the-line of street ................. ......7 ...................................:...................................................................................................
17. How near the line adjoining lot. Right ............ 7. ................: Left...................................; Rear ......?.0................
18. Nearest building is ...............r.....feet in a...............................- ............ direction .......r-------------------------------------
19. Material of the floor ............. tT.;t. -...................._...............
20. Size of timbers, 1st ..... ..0..:K........ ; 3rd ........................: 4th ..............................; 5th ..............................
21. No. of feet span .........................._...:R.................................. ; Distance on centers ...........Z.'k........................_.......................
22. Will the building be erected on solid or filled land .............. ?, /..... ................................................... ..............
y
23. What is the material of foundation .... '.f. .1.?.CIZ- .'IV9-1...........................................: Footing
S
24. Will the roof be flat or pitched ...... " .......................; Covering....; ,!",,t,,r.......
25. Heat; steam, hot water, furnace, stoves ...........,.:-- .....................: Power oil burner .............s;..............................
26. Fireplace .................................`.�...-�.......................; Insulation ...............................................................................................................
27. How many sinks . Zv Toilets-,&-ie.,; Lavato ries--.7. 7-4;Bathtuba-.1.V Showery-.td.; Settubs?�. .Z>
28. City Service; Water ........................ Sewer ........ Road Surface .................... .... ; Sidewalk .........
29. Is lot on accepted street .....`.
30. Estimated cost (must be filled out) .... ... 7 .. ,.
Applicant agrees to give the Inspector of Buildings 24 hours' notice before lathing or
plastering this building. This building will conform to the requirements of the law.
Signatureof applicant ......... .. ....».... , z. .. .... . . .... ... ......................................................
No........f�.�.�-,... --......
REMARKS
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............ca...1^............ ... ..1� . ...e.................CG?f a -s - � ..t,� ..............<... E:r ....................................
.......................................................................I........._...................................................................................._.....................................................................................
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LUNINU tittiml 1 3
7,0 t
APPLICATION .
Toning ordinance Socti,)n 10." iv, Fi1 Pao. 1nn file
m or 4r-s 4p
-�7 -/71
lddress 28 A(A,J r e r,,-
lelephone Telephone
This section is to be filled Out in accordance t:),, the "Table of Diriciisionnl and
Density Perplatione:, (Z. A.PTI Ll,' VI
,joning TT:7 c Lot Front Derth S 0 UZI C!7,- 1;1x.Bld. Min. Op.
district Area. "Ad t 1i Frort Sid Cover. Space
Exislin- I %
V FA
r e s en t Proposed
lark the appropriate box to indicate the iicx of the p�rcol:
1"'On-Conforil-lint; Lot :,nd/or Strlticturc. Specify
Co Residential Sincle F•--iily V1iit. =1'u1ti-Fz1ni1y
Durlex =0the2
Busine,ss
Industrial
Instituti.0-1-
Subdivision
CUcu
Subdivi�ior i;,ith
P1,11111ing hoard Approval:
Zoning Board Approval (Spccipl Permit P).O: V,,rinlic •)
= Cit:y council (Special Exccption S. 10.101 ITO
,'3terShed Protection District Ovey'lty: Sect. ;:IV) - =
larkin- Space Requireuientc: (Z.C. 'sCct. 2.1) Require-V Iro Dose,'
I
,oadinG_I Space Requirements: (Z.C. ;ect. 8.211 RequireAL4=11proposee
= Yes T'o
,inns• MO. Art, VII)
3 =Yer, 1"'o
nvirormental Performa'nce Standards: (7..0. Art. XJI)
:'lot Plan Yes ro Site Flan Q yes
S. 10.2) 10.2 and 10.11
r5rwitcd: t v ED
This section for Of IC11,L use only:
Approval as presented:
[=Modific�atioiis recccz-ary for
[-]Return: (Fore iriformntinn m-,r-led)
Denial: Relrorzs:
min.
ate f f e r Tate
Sigr.,qture of Ap,,lic-lrnt
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.
SIGNATORE''OF AGEN
s .
ADDRESS "
(NUMBER) (STREET) (CITY)
APPROVED BY T1TLf
DATE 19
DEPT. FILE COPY
z
BUILDING
PERMIT VALIDATION
DATE 19 PERMIT NO. /Z
APPLICANT ADDRESS 7e a/10/1
�11 jk��
0.) STRE ) (CONTR'S LICENSE)OF
PERMIT TO "� (_) STORY C.gn�'�710 NUMBERNG UNITS f
1TYP OF IMPROVEMENT) NO. �— ROPOSED USE)
ZONING
AT (LOCATION) ale& DISTRICT�-
N0.) (S EET)
rn BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
a SUBDIVISION LOT BLOCK SIZE
m
U
O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
�T /} `f/''1
Z TO TYPE _ USE GROUP BASEMENT WALLS OR FOUNDATION_S ���i/
f (TYPE)
It
O
!L REMARKS:
AREA OR PERMIT
VOLUME ESTIMATED COST $ FEE ^�
(CUBI /SQUARE FEET)
OWNER
BUILDING DE
ADDRESS BY ,_.,.
(Affidavit on reverse side of application to be completed by authorize .gent of owner