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NOTE:IN ORDER THAT THIS APPLICATION MAY BE ACCEPTED,THE DATA CALLED FOR BELOW MUST BE SO SET FORTH THAT
WE CAN DETERMINE FROM THE APPLICATION AND THE ACCOMPANYING PLANS WHAT THE EXISTING CONDITIONS ARE AND
WHAT THE FUTURE CONDITIONS WILL BE.
Plans,in duplicate,must be filed with this application before a permit will be granted,one of which,upon issuance
of the permit shall be kept at the site during the progress of the work.
New...............❑
Addition........❑
No.................—D, Zone..................., Type..................., Map..................... Parcel..................... Alterations ....❑
Repair............❑
g ~� CITY OF NORTHAMPTON Demolition....El
s e
MASSACHUSETTS
Application for other than a Dwelling Permit
(To be filled out in ink OR on a typewriter) C3/
To the Building Inspector:
Date..................�r...�v............. 19 Z
Application for a permit is hereby mao according to the followin :-
, ''11
1. Location, Street and N �.. �? .................... 1..................1........ �7'.!��... ...........,
,USf �� � d ....................tNo.................... «
2. Nearest cross street... ..................`..... ............... . . lp...................../.
3. Owner's name... ! ,'!1. ...f l.f. .�Q �Addrei. .............................................................
4. Architect's name.............................................................. Address ...............
... ........
......... .... .
5. Builder's name WI�21lc� t!'• Latl►!�Y' Gl��)1� y..a 1...-7.. .... ........... .. Address a .... ........... .:
6. Use of building,Vr ent..................................... Proposed .........................................................................
7. Building fronts on how many Streets?.....................................................................................................................
8. Is building in fire district?........................................................................................................................................
9. Size of building,Width in ft. , Length to ft. , Height in ft...........................
10. Distance of building from Street Line................ left lot line..........., right lot line..........., rear lot line...........
11. Type of construction(check one): 1—A.......... 1—B .......... I-C .......... II.......... III.......... IV.......... V..........
Stories B 1 2 3 4 5 6 7 Roof -
Story heights in ft.
Thickn's of walls in ins.
Material of walls
Material of floor/roof
Design live load
Design dead load
Occupancy or Use
No.of persons/families
No.of stairs
12. Soil under footing is.................................................................................................................................................
13. Depth of footing below grade................................... ft. Will piles be used.
14. Area of entire building(Present plus new) .
15. Type of roof flat....................... pitched................... Material of roof covering..................................................
16. No.of elevators.............. Method of heating.............. System ................................. Fuel .................................
17. Are live loads noted on drawings? ............... Are all other structural conditions noted on drawings?...................
18. Building(will be)(is)equipped with sprinklers?.................................With sprinkler alarm?..............................
19. Is building to be used as a factory,workshop or mercantile or other establishment employing 10 or more persons?
...................................................................................................................................................................................
20. Is building to be used as an office building,dormitory,hotel,family hotel,apartment or boarding house,lodging
house or tenement house having 8 or more rooms above the second story? ...........................................................
21. How many exits(per floor)to street? ......................................................................................................................
22. Is building a"Place of assembly"as defined by the General Laws? ............ ...:......................................................
23. Will building conform to the General Laws? ......................... Building and Zoning Ordinances?.........................
24. If a garage,distance from nearest building? ......................................................................................................... ..
25. If an addition,alteration or demolition,when was buildi erected?.................................. ................... ..... .... .
26. Estimated costs:
The un ersigtied c ifie hat the a ve s t ents are to the 6
General$......................................... of his r owle a elief.
Plumbing......................................... � f� . ` ..�... ...:.. .
:.. .. . ...�............... y
_....... ...... f g . .. ,. .. .
Gas Piping....................................... �, S' azure o owner,architect or en ine ryl / jj�
Sprinklers........................................ WRITTEN DISCRIPTION OF WORK TO BE DONE
Heating (Use blank half of reverse side,if necessary
............................................
Electric............................................ � ...: ..................... . ...:...........................
Other............................................... ...............................................................................................................
Total$....... �.. .................... ...............................................................................................................
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Date Filed- File No. _
ZONING PERMIT APPLICATION (910.2) �
Y. Name of A p,lcant: � ; ;V�T1 1� 1�JAI 7TYdF I/ �a neei/� /.}MO
Address: lL�TD�t iD Z ' SiT� . Telephone
2 . Owner of Pro erty: /AjC .
Address: � OSs f�.fi}TN 'b Telephone, c
xg ��a
3 . Status of Applicant: Owner Contract Purc aser Z y
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# 2-5— Parcel.#J,
Zoning District(s) (incl e verl ys) U
Street Address C BOSS � i
Required
5. Existing Proposed by Zonin
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%B1dg.Coverage (Footprint)
Setbacks - front
side
rear
Lot size
Frontage
Floor Area Ratio
%Open Space (Lot area minus
building and parking)
Parking Spaces
- : - Loading _
Signs
Fill (volume & location)
6 Narrative Description of Proposed Wo k/ -oject: (U tional s.he is
if n cessary) � � C",
� ���Jt
7. Attached Plans: Sketch Plan Site Plan
8 . Certification: I hereby certify that the informato containe herein
is true and ac ate to the best of my knowledg
i
Date: Ile? �� Applicant's Signature: \}
-/ - - T -THIS SECTION FOR OFFICIAL USE ONLY:
V Approved as presented/based on information presented
Denied as presented
Reason for Denial:
Signa i ing Inspec Date
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