25A-101 (6) For ALL buildings within Fire District and for other buildings costing$10,000.00 or more, plans
and specifications must be submitted to the Inspector of Buildings for examination and approval.
If building is to be moved give details relative to proposed location as for a new building.
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176,q A pp licat air:. for Permit to Build
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Northampton, Mass.. ..............».0..: .s..................19..
To the Inspector of Buildings:—
The undersigned hereby applies for a permit to build, move, alter, or repair, according to the
following specifications.-
1. Owner's name ...L. .» .»............LA..!/...............................................................................................»....»..........
2. Owner's address ..._.. ..».»..........».»..................................»................................
3. Architect's name ..................................................».....................................................».».............».....................................................................
4. Builder's name ....».
.... »........».......».......
...V� ....L� .�: z.o.. ...... ..�.� . .{ ..... A..��7.:t &AL..
5. Builder's address �.�.a..sr..1.�j .. . .... .. ••••» •••»r••••••••
6. Location of Building. Street No. a.`. .:.-x..... .ice"..._.....i .?
7. Is this a removal or new building...................................................................»..........................................................................
.....».
8. If removal, from where ......................................................._............................_....................................................................................
9. What is the purpose of building ............................................................................................................................................................
10. Material of building ........».........:............».»....»........................................................._............................».............».........................................
11. If a dwelling, for how many families.............................................Number of rooms ........_.........................................
12. Is there to be a store in the building ............».......................».......»...............................»...........:.......»............................................
13. Size of building, No. of feet front .....»....»...........;No. of feet deep ......................; No. of stories ...........»....»..
14. Size of ell, No. of feet front ........................: No. of feet deep ........................ No. of feet high ..........................
15, Size of Lot ........»..........».».................................».......................Feet Wide ...........»..................».. Feet Deep .................».........»..
16. How near the-line of street .......................................................................................................»....».......»......................................».».....
17. How near the line adjoining lot. Right................._..........».....; Left...................................; Rear...........»...................
18. Nearest building is ...............................feet in a..............................................._..... direction .........................................»....».....
19. Material of the floor...............................................................................................................................................................»....».....
20. Size of timbers, 1st ...........»....».....; 2nd .....».........»..... ; 3rd ........................: 4th .............................; 5th ............................
21. No. of feet span.»........».............»...........................»............. ; Distance on centers .....»............................»..............................»..
22. Will the building be erected on solid or filled land .....»..................................................................................................
23. What is the material of foundation.....»....».»...................».............»....»....»...................»....».......; Footing .......................
24. Will the roof be flat or pitched ...........».»....»........................................; Covering..............»....»....».......................................
25. Heat; steam, hot water, furnace, stoves........................................; Power oil burner .....».....................»...............
26. Fireplace .....».............».............»..........».....................; Insulation ..............»..................................................».......................................»..
27. How many sinks ............: Toilets .....».....; Lavato ries..».....; Bathtubs.....»..; Showers............; Settubs»...»..
28. City Service; Water.......................Sewer ........................: Road Surface ..........................; Sidewalk .................».....
29. Is lot on accepted street ...........................................................................................................................................................».......
30. Estimated cost (must be filled out) . :::..........»3,2p0:U
Applicant agrees to give the Inspector of Buildings 24 hours' notice before lathing or
Plastering this building. This building will conform to the requirements of the law.
Signatureof applicant .....»...... ..... .. ».»».. .......»....»........................................ ...............»......................
D .........................................
REMARKS
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Cl.�:`.v�,Ssr't;:i;::`:„1.�:»!�;;,1�••'»�„t,,�r..�...1C:.»..k�.»1?C..?.�`.'.:.:.:�».,..�..`.?
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41
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APPLICATION
Zoning Ordinnixe S( cticn File Too. Fl-111 File
Telephone Telcphnnc
Past Existina
[--1
Industrial
|�l Ioatitutjnr~]
F� Subdivis.ioo Beou] -r -P.U.D"
�--1 Cloot'r F---1 nU1er
Gubdivioinu ritb '/A�)rrnv�l-�ot-�r/nirp��"-3tnm9�
[--lPlanning �onrd
F--1Znoiu,9 RourU Approval
F--1 (3porinI Porujt j().0:�: Vxri�nC��ty Council (Special ti r)
Watershed Protection District Overlj�y: MO. Sect. ,'IV) Yes I'TO
Loading Space Requirement,-: Z.C). '—7e c-'t" . '8.2) Repirc-(J—rrf)j.-,,ored
T�i[,- sc,cti011 for OFFICIAL use only:
[--lHodifinotioun occooeory lor
[--lBe.toro: (Boro iufurmnti�u oer�ed)
�--lDeoimI: Bpnrous:
mv YIN, VIL-j-A 'e�
f ♦s
I hereby certify that the proposed work is authorized,-hy thef,owner_of record
and { have been authorized by the vw.n�r:� .b,*_mike. this v0plrcation as big:.
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER): (STREET), (CITY)'
APPROVED BY TITLE
DATE 19
DEPT. PILE COPY
Z0
City of Northamptan .ILDING a
Massachusetts Buildings Office of the Inspector of Buildings VALIDATION
DATE /4'IV 20 1977 l RMIT N
APPLICANT ADDRESS
.. (NO.) (ST EE T) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
Jh ZONING
AT (LOCATION) '? DISTRICT
(NO.) (STREET)
a BETWEEN AND
rn
(CROSS STREET) (CROSS STREET)
LOT
IL SUBDIVISION LOT BLOCK SIZE
m
a
0 BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
W
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
f (TYPE)
0:
O
LL REMARKS:
AREA OR r� u FEEMIT $ /2,(JJ
VOLUME ESTIMATED COST
(CUBIC/SQUARE FEET)
OWNER -A e - AP BUILD
ADDRESS BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)