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NOTES and Data — (For department use)
A) 37+7 5 7? �
S C'
t
IV. IDENTIFICATION - To be completed by all applicants
Name Mailing address — Number, street, city, anti State ZIP code Tel. No.
Owner or
Lessee 5701 q- g Builder's
L. l'Jli4il��LS � S I Wt- /Jt 'i+/��-Qia� License No. Q Q(y
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.
Signatur of applicant Address Application date
1k t ✓� S I -� D ��i 21(12 JR. 7
0 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
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 42Z\ FOR DEPARTMENT USE ONLY
Permit number
Building- c% ` fr Use Group
Permit issued I Asti 1 U 19 `y
Building ,i Fire Grading
i .s
Permit Fee $ Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee
' TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
$ 0 OFFICE of the INSPECTOR of BUILDINGS
�V, Page- f�� Plot_ r-):,5 APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O
I• AT (LOCATION) I 1"�� G (mac ty.� 7'z�.� ZONING Ii�I�y"l
DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN- �Ci(G(ri pLLT � AND T—,
151ti4u 5
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT _BLOCK SIZE
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
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 One family 18 ❑ Amusement, recreational
of new housing units added, if any,
Two or more family - Enter 19 Church, other religious
in Part D, 13) 13
number of units- - - - •> 20 ❑ Industrial
41n 3 Alteration See 2 above) 14 ❑ Transient hotel, motel, 21 Parking garage❑ ❑
Repair, replacement t
acement 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 ❑ Carport 24 ❑ Office, bank, professional
6 ❑� Moving (relocation)
17 ❑ Other - Specify 25 ❑ Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP 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
y,, processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement•,,,,,,,,,,,,,,, i.. .i school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office building at industrial plant.
7'o be installed but not included If use of existing building is being changed, enter proposed use.
in the above cost
a. Electrical.....................
b. Plumbing ..................... c7 lC
c. Heating, air conditioning........ C<t"
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT is f t�(�
III. SELECTED CHARACTERISTICS OF BUIL ING — 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 Z_
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�Privwe (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........................
36 Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 j Electricity 44 L-] Yes 45 N
No 53. Number of bedrooms..............
38 ❑ Coal ^�
39 ❑ Other - Specify Will there be an eleyatoO Full.......... G�
54. Number of
46 r-� Yes 47 E� No bathrooms Partial........
DEPT. OF BUILDING INSPECTIONS BUILDING Z0
+ ! 212 Main Street '< ° CD
Northampton, MA 01060 PERMIT
p�
VALIDATION
25A - 55 DATE December 4, 19 84 - PERMIT NO. C)71 J
APPLICANT J.A. Wright & Co. , Inc. ADDRESS 115 Tnrh,-,trial Drive 040674
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Alteration (_) STORY Onp Fermi lv (� DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PRQPDS D USE)
ZONINGS
AT (LOCATION) 15 Swan Street DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK_ SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY -FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: remodeling one floor of this home We will change tbt= f 1 nnr T,1 an add nno J,;j nd .7
close off two windows and not alter the exterior walls in any other way
AREA OR $' 10,650 FEEMIT
ESTIMATED ATED COST _
(CUBIC/SQUARE FEET)
OWNER Susan Hollin sworth BUILD
ADDRESS wan Street, Northampton _ .Y "�
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY • PINK - ASSESSORS COPY p21.111'