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IDENTIFICATION — To be completed by all applicants Name Mailing address — Number, street, city, and State ZIP code Tel. No. vet b.s L 17r� 1�,. / 5 C:)( o i Owner or Lessee �.3 Bui Ider's C License No. ontroctor 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. Signature of applicant Address Application date DO NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Required Check Plan Review Date Plans B Date Plans BY Notes Fee Started Y Approved BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL $ OTHER $ VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS ate Permit or Approval Check Obtained Date Number By or Permit Approval Check ObtOained 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 I Building � Use Group Permit issued 19 Building h Fire Grading Permit Fee $ 1[�A� Live Loading Certificate of Occupancy $ Occupancy Load Appr e Drain Tile $ Plan Review Fee $ ' TITLE CITY OF NORTHAMPTON MASSACHUSETTS OFFICE of the NSPECTOR of +BUILDINGS Page ` ' Plot fl APPLICATION FOR ZONING PERMIT AND INSPECTOR BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. 0 ZONING //// / / 6 �^� �"r - ��- DISTRICT I• AT (LOCATION) 66 ------II YY LOCATION (NO') (STREET) OF BETWEEN AND (CROSS STREET) BUILDING CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE N II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D � M A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use M 1 D New building Residential Nonresidential 2 E] Addition(1/ residential, enter number 12 One family 18 Amusement, recreational of new housing units added, if any, in Part D, ]3) 13 Two or more family - F.nter 19� Church, other religious number of units- - - - -T 20 Industrial 3 E:] Alteration (See 2 above) 14 Transient hotel, motel, 21 C � Parking garage 4 Repair, replacement or dormitory - Enter number 5� Wrecking (11 multifamily residential, of units ------- - -i 22 � Service station, repair garage enter number of units in building to 15 Garage 23 �� Hospital, institutional Part D, 13) 16 Carport 24 Office, bank, professional 6 �� Moving (relocation) 25 Public utility 17 C� Other - Specify 7 Foundation only 26 School, library, other educational B. OWNERSHIP 27 L Stores, mercantile 28 Tanks, towers 8 Private(individual, corporation, 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 f, processing plant, machine shop, laundry building at hospital, elementary 10. Cost of improvement,.....•......... GJ 0 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 1-j /- q ' 7 ^ a. Electrical....................... //Q✓L�G If �E �.�i�eG�� b. Plumbing ..................... c. Heating, air conditioning.......... d• Other (elevator, etc.)............. it. TOTAL COST OF IMPROVEMENT 1$ 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 48. Number of stories.............. 30 Masonry (wall bearing) 40 Public or private company 41 n Private (septic tank, etc.) 49. Total square feet n floor area, 31 n Wood frame all floors, based on exterior 32 Structural steel dimensions ..................... 33 concrete H. TYPE OF WATER SUPPLY 50. Total land area, sq. ft. ........... 34 Other - Specify 42 Public or private company 43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed ....................... F. PRINCIPAL TYPE OF HEATING F I. TYPE PF MECHANICAL 35 E Gas jWi ll there be c`Mtral air 52. Outdoors........................ 36F] Oil =�tnionmg� L. RESIDENTIAL BUILDINGS ONLY 37 j Electricity a 4 Yes 45 No 53. Number of bedrooms............. 38 ❑ Coal 39 n Other - Speci/y Will there be an elevator m Full.......... 54. Number of 46 [ bathrooms ] Yes 47 �i� No Partial........ h, 9s INI. DEPT.OF BUILDING INSPECTIONS BUILDING �O � f 212 Main Street 1060 PERMIT o< Northampton, MA 0 <a 25A - 58 VALIDATION DATE C'Ant 1Q P RMIT NO. 606 APPLICANT Stephen Moos ADDRESS St. r (N0.) (STREET) (CONT R'S LICENSE) PER Rea MIT TO / p (it Re lacement Two Family NUMBER OF _) STORY —DWELLING UNITS p (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) 16 Marshall Street ZONING AT (LOCATION) DISTRICT (N0.) (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: permit for repair existing porch AREA OR ESTIMATED COST $ 700-00 FERMIT 1 0.00 VOLUME (CUBIC/SQUARE FEET) OWNER Same as Applicant B , D P ADDRESS Same as Applicant' s WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PIN - ASSESSORS COPY PINT P