36-184 (5) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
t
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NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
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BOCA FORM APEBP — 669 01969 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.
1.
Owner or Lry�i4al'i J ��4ti �l✓� /JtJ:��s FIT `� F16& CA --
Lessee 6)/
r 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.
Sign u of pplica Address Applic tion date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
9 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL Is
OTHER Is
VI. 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 19f�
Building Fire Grading
Permit Fee $ Live Loading
Certificate of Occupancy $ Occupancy Load
Ap ed by: ,
Drain Tile $
Plan Review Fee $
TITLE
K
NOTES and Data — (For department use)
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS ����/ V[J
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
• AT (LOCATION) c,IL3 '^ 's TS � D STR C
LOCATION (NO.) (STREET)
0 F 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
-•I
1 New building Reside 'al Nonresidential
2 F-1 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
3 ❑ Alteration (See 2 above)
number of units- - - - --)P. 20 ❑ Industrial
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)
6 [_1 Moving (relocation) 16 F-1 Carport ` 24❑ Office, bank, professional
17 Other - Specify Cdr'L ly Y Sh%F 25 ❑ Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP S 7 C CZ1? 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,,,,,,,,••,•,,,, { 4' 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 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 SEJ(N��/A/GE DISPOSAL J. DIMENSIONS f
30❑ Masonry (wall bearing) 40 ❑ Pu� Yo private company 48. Number of stories............ /
31 Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square feet floor area,
all floors, based on exterior t1��
32❑ Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATFR SUPPLY
34 ❑ Other - Specify 42 ❑ Publi p"iSvate company 50. Total land area, sq. ft. ...........
43 F-I 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...........!U. ........
conditioning?
36 Oil L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44❑ Yes 45 ❑ZNo 53. Number of bedrooms....lV- ...
38 ❑ Coal y
39 ❑ Other - Specify Will there be an elevator? 54. Number of Full..........
46 ❑ Yes 47 b/No bathrooms
Partial.......
All
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I hereby certify that the proposed work is authorized by the owner bf record
and 1 have been authorized by the owner to make,,,this application-as his
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE lq
DEPT. FILE COPY
DEPARTMENT OF BUILDING INSPECTIONS Zo
212 MAIN STREET BUILDING Q IL
NORTHAMPTONt MA. 01060 PERMIT
VALIDATION
36 - 184 Code #79
DATE Apr41. JR_ 19 80 PERMIT NO, 188
APPLICANT hnIX1-0 G Do Le ADDRESS 90A B113fta pit Rd.
(N0.) (STREET) (CONTRIS LICENSE)
PERMIT TO (_�,__) STORY y NUMBER OF
YPE IMPROVEMENT) NO. LttilitshedN storage DWELLING UNITS.- 1
ZONING
AT (LOCATION) 908 Burts Pit Road DISTRICT
(NO.) (STREET)
ao BETWEEN AND
a
(CROSS STREET) (CROSS STREET)
n LOT
m SUBDIVISION LOT BLOCK SIZE
p BUILDING IS TO BE 24 FT. WIDE BY 74 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
� (TYPE)
(L REMARKS: Construct wood frame uti14 ty shed for store .pur-poses,,
AREA OR
VOLUME 299 ESTIMATED COST $ 27000 FEEMlT . 10.00
(CUBIC/SQUARE FEET)
OWNER _ChaIlBS SO Doi Ze BU
ADDRESS 908 SL1rt8 Pit Road- N'tom-' Na- 01060 BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)