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I . T. �gt ,.... - 8 L 4 4+4,4`� �; 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. ,. r i � Owner or Lessee o O 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 auth ' d agent and we agree to conform to all applicable laws of this jurisdiction. Signature of applicant Address Application date ±214 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 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 VII. VALIDATION Building jp 7 FOR DEPARTMENT USE ONLY Permit number Building p� Use Group Permit issuedII 19_y Building 7- Fire Grading Permit Fee Live Loading Certificate of Occupancy $ Occupancy Load A d by: Drain Tile $ � Plan Review Fee $ TITLE NOTES and Data — (For department use) CITY OF NORTHAMPTON �_3 OFFICE OF THE INSPECTOR OF BUILDINGS 212 MAIN STREET APPLICATION FOR NORTHAMPTON, MA. 01060 PLAN EXAMINATION AND BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O ZONING I• AT (LOCATION) /3 ;;tWCtLc��,ty{/ i //Z DISTRICT „ LOCATION (NO.) (STREET, OF BETWEEN AND BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE N 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 1 New building Reid ti al Nonresidential 2 ❑ Addition(If residential, enter number 12sOne 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 Alteration (See 2 above) 14 ransenoe , motel, E] T it hotel, tl 21 ❑ Parking garage 4 ❑ Repair, replacement or dormitory – Enter number 5 F-1 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 F-1 Moving (relocation) 7 ❑ Foundation only 17X Other – Specify 1 25 ❑ Public utility 11 LL. 26 ❑ School, library, other educational B. OWNERSHIP 27 ❑ Stores, mercantile 8 ❑ Private (individual, corporation, \/ 28 ❑ Tanks, towers nonprofit institution, etc.) -CIO s �IC 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 $ III. SELECTED CHARACTERISTICS OF B ILDING - 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 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 0 MECHAN'CA 51. Enclosed ....................... 35❑ Gas Will there be entral ai 52. Outdoors........................ 36 F-1 oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37 CN Electricity 44❑ Yes 45 ❑ No 53. Number of bedrooms.............. 38 ❑ Coa I 39❑ Other– Specify Will there a an elevator? Full.......... 54. Number of 46 ❑ Yes 47 ❑ No bathrooms Partial....... I 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. r SIGNATURE 0� AGENfi ADDRESS - (NUMBER) (STREET) (CITY) APPROVED BY TITLE DATE 19 DEPT. FILE COPY -DEPARTME111T OF BUILDING INSPECTIONS �� 212 MAIN STREET BUILDING aak, ` NOMHWTON, MA. 01060 PERMIT VALIDATION 36 - 157 DATE September 2$, 19 79 PERMIT NO. $3 APPLICANT Ruth LOrigrldge ADDRESS 1136 Rurtg Pit Rd. (NO.1 (STREET) (CONTR'S LICENSE) NUMBER OF PERMIT TO A17X_ -ghpci (�_) STORYS.nraRP DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ZONING AT (LOCATION) IIXA Rirtg ,Pit Rosid DISTRICT E (NO.) (STREET) - of BETWEEN AND a (CROSS STREET) (CROSS STREET) LOT CL SUBDIVISION LOT BLOCK SIZE ao t 0 BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION in O O Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) 0 REMARKS; Conat'M7nt urnnd atnraae She AREA OR E ESTIMATED COST . 96 .0© PERMIT VOLUME $ 10,00 VOLUME ��PP (CUBIC/SQUARE FEET) \ OWNER WJ 11 i am T- TTT & Ruth Longridge B D ADDRESS 113(1 T%ir'g Pit Ed- , North&=ton_, Ma, B (Affidavit on reverse side of application to be completed by authorized agent of owner)