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36-189 (14) VIII. ZONING PLAN EXAMINERS NOTES DISTRICT USE FRONT YARD SIDE YARD SIDE YARD REAR YARD NOTES IX. SITE OR PLOT PLAN — For Applicant Use rpF..t .a a s�'f F§r•-e r s t'-,'§a a C a,--.--a� m �x c'.. . 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S e t 1 7- ¢ 1 ^ +- Y .r: r+ Y b a .y t th s a.... IF - z 4: t'»ga,` r -o-§ . i - -at " � t w-I• r 1 },d y a 4 k o- f 4 ..6{" Y `} s� gP -t a' r §} r ? p4 14 I t t Fa j ��- Y f t j � L a.<-V- -r a '4,: s �� g d...- p. p.y} p. �... gr y4a, a ,_"_ ,b$$. ,�;." T� k _G { i-t- rP-t -+ r--i+t .i'' ty--f } ri __ s 7 ."i: 9't g t-4t a` 7r ,.. t tt ax T.t.',-st tf°t dT i§ °fir r � 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. n � Owner or 41' Lessee 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. Signdtu i re of applicant Address Application date ' �C j DO NOT 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 Is VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Date Date Permit or Approval Check Obtai ed 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 V11. VALIDATION Building FOR DEPARTMENT USE ONLY Permit number Building '. Use Group Permit issued �� 19 �- Building Fire Grading Permit Fee $ ZZ"!Lit) Live Loading Certificate of Occupancy $ Occupancy Load Appr ved by: ,--. Drain Tile $ / �' Plan Review Fee $ TITLE NOTES and Data — (For department use) a CITY OF NORTHAMPTON 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: I, II, 111, IV, and IX. O ZONING I• AT (LOCATION) j t, t DISTRICT LOCATION (NO.) (STREET) OF BETWEEN AND BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE H II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D —� z 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 12KOne 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 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) 16❑ 6 F-1 Moving (relocation) Carport 24❑ Office, bank, professional 17❑ Other — Specify 25 E] Public utility 7 F—] Foundation only /7 26 ❑ School, library, other educational B. OWNERSHIP � �`��' � {+y�. 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,,,,,,,,,,,,,,,, 6( ' 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 $ J :,r 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 30❑ Masonry (wall bearing) 40 ❑ Public or private company 48• Number of stories................ 'f 31 Wood frame 41 M 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 F-1 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 TYPE OF MECHANICAL 51. Enclosed ....................... 35 Gas i there be central air 52. Outdoors........................ 36 Oil condi Wing? L. RESIDENTIAL BUILDINGS ONLY 37 ❑ Electricity 44 ❑ Yes 45 ❑ No 53. Number of bedrooms.............. 38 ❑ Coal 39 ❑ Other — Specify Will re be an ele or? Full.......... 54. Number of +--�� E] Yes 47 o bathrooms Partial....... . ., x. s n S. 3 a Yw LL ` k"5 b 4 I wow Val Mw in `K w u E t y �rJa �� � �,�.{. ,� � �� ��`:'� a' �< v`` F �$t�' .fi�� ��� ���fri i1m' i� $rT2Ks,,,h � ' n �1 rs a ���i V Ji 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. SIGNATURE OF AGENT ADDRESS (NUMBER) (STREET) (CITY) APPROVED BY TITLE DATE —19— �p L� DEPT. FILE COPY g� z o /1.. BUILDING PERMIT °' VALIDATION DATE � � o"°' �T/NO APPLICANT ADDRESS (NO.) (STREET) ICONTR'S LICENSE) NUMBER OF PERMIT TO ) STORY DWELLING UNITS (TYPE OF IMPROVEME T) NO. (PROPOSED USE) ZONING J AT (LOCATION) DISTRICT (N0.) (STREET) w BETWEEN AND 'O (CROSS STREET). (CROSS STREET) w IL LOT m SUBDIVISION LOT BLOCK SIZE a - U 0 BUILDING IS TO BE FT. WIDE BY FT, LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION M O Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION I 1� (TYPE) 0: LL REMARKS: AREA OR VOLUME ESTIMATED COST $ -76C) FEEMIT ` (CUBIC/SQ ARE FEET) E OWNER Wi/y/l) w BUILD V , ADDRESS BY (Affidavit on reverse side of application to be completed by authorized agent of owner)