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NOTES and Data — (For department use)
IV. IDENTIFICATION To be completed by all applicants
Name Mailing address %umbcr, street, rite, aiid ltutc ZIP code Tel. No.
Owner or
Lessee
e"r-t/,) Bui Ider's
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 p f applicant
-n t Ad d/re ss
Application date
.. I
6'r 7
<
0 0 N O T W R I T E B E L O W T H I S L I N E
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 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
Permit number 7a
Buildin
Permit issued ssued 19
Building
Permit Fee $ d d
Certificate of Occupancy Appr
,p4'6d by;
Drain Tile
Plan Review Fee
TITLE
of Northampton
�7i48�iChltS�ttB
(®ffire of the �ngvtrtux of 'Puilbings
APPLICATION FOR
Plot /C, 5 ZONING PERMITAND
Page BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. Z
O
ZONING `
5 l' h.J /^/�1(/ �—� �
(• AT (LOCATION) ` DISTRI
LOCATION (NO.) (S REET)
OF BETWEEN AND
BUILDING (CROSS STREET) (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 ❑ New building Residential Nonresidential
2 ❑ Addition(If residential, enter number 12❑ One family 18 ❑ Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13®""fwo or more family — Enter � 19 ❑ Church, other religious
number of units— — — — --)P- 20 Industrial
3 Alteration (See 2 above) 14 Transient hotel, motel,
❑ 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 El 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 E] Office, bank, professional
6 ❑ Moving (relocation) 25 ❑ Public utility
17� Other — Specify
7 ❑ Foundation only 26 School, library, other educational
B. OWNERSHIP / 27 ❑ Stores, mercantile
Tanks, towers
8 Private (individual, corporation, / j� i�f,'LL. 11 s 28 ❑
nonprofit institution, etc.) L" ��" 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
1 6,c9 processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement................ s(/l-} 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. D
O
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS M
48. Number of stories...............
30 Masonry(wall bearing) 40 ❑ Public or private company
41 ❑ Private (septic tank, etc.) 49• Total square feet of floor area,
31 Wood frame p all floors, based on exterior
32❑ Structural steel dimensions .....................
33❑ Reinforced 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 ....................... r
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL O
35 Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 ❑ Yes 45 ❑ No 53. Number of bedrooms..............
38 ❑ Coal
39 F—] Other — Specify Will there be an elevator? 54. Number of Full..........
bathrooms
46 ❑ Yes 47 No Partial........
I hereby certify that the proposed work is authorized by the owner of record
and I have been authorized by the owpel-,to-,make this application as 'his
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 1q
DEPT. PILE COPY
z0
*- CITY OF NORTRANPTON BUILDING Q 0.
NORTHAMPTON, MA. 01060 PERMIT 25A - 703 VALIDATION
DATE March 30, 19 78 PERMIT NO. 7
APPLICANT David R-hri e-kl anti ADDRESS � �tharmsrn vRnt)e
(N0.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Rnalnan Parah (Z) STORY Rgnjdang3w DWELLING UNITS 2
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) 5-7 She�m A4enue DISTRICT
(NO.) (STREET)
Ch BETWEEN AND
v (CROSS STREET) (CROSS STREET)
a
LOT
a SUBDIVISION LOT BLOCK SIZE
m
u BUILDING IS TO BE FT, WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
2
0:
o REMARKS: Close in tad, floor porch -
AREA OR ESTIMATED COST $ 200-00 PER lo.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER David Strickland BU D
ADDRESS 7 Sherman Avenue. Northe=t=. Ma_ BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)