25C-111 (2) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES —f LA j O V N S-7'&' L) N ( %i�I M
IX. SITE OR PLOT PLAN — For Applicant Use
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BOCA FORM APEBP — 669 01969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
ATE CI tq �. _ n l v Nb ff,4n� V o/al a
Owner or '
Lessee
/}� n� yr e
2. 162 511RJ� T J���E� PmAk /V� 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.
n:tu e f applicant Address Application date ge
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plan Review Date Plans Date Plans
Plans Review Required Check Fee Started By Approved By Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date D
Permit or Approval Check Obta ned Number By Permit or Approval Check Obtta t ed 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
Building �. r Use Group
Permit issued T 19
Building Fire Grading
Permit Fee i/ .- Live Loading
Certificate of Occupancy $ Occupancy Load
$ Aproved by:
Drain Tile
Plan Review Fee $
TITLE
NOTES and Data — (For department use)
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 PLAN EXAMINATION AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O
ZONING
I• AT (LOCATION) ' �� lqUF- DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vf
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,
in Par[ D, 13) 13❑ Two or more family — Enter 19 ❑ Church, other religious
number of units— — — — -->
3 Alteration (See 2 above) 20 ❑ Industrial
14 ❑ Transient hotel, motel, 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 F-1 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) Public utility
7 ❑ Foundation only (1t 25
17® Other — Specify ❑
26 ❑ School, library, other educational
B. OWNERSHIP �i tyC+� l/4 v C7�IS S1�L 27 ❑ Stores, mercantile
8 [ 'Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) �U1 lvitU�c� l��i to mih, 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................ VU > 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.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS nn
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 F-1 Other — Specify 42 4 ublic or private company 50. Total land area, sq. fT. ...........
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed .......................
35 ❑ G s Will there be central air 52. Outdoors........................
36 Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 ❑ Yes 45 [j�'No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other— Specify Will there be an elevator? 54. Number of Full.......... I
46 ❑ Yes 47[vj No bathrooms
Partial....... - —
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hereby certify that the ,proposed work is authorized by the owner of record
and I have been authorized, by the owner to make this application as kris
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
DEPT. FILE COPY
DEPARTMENT OF BUILDING INSPECTIONS I �t ZO
212 MAIN STREET BUt�Q11G as
NORTHAMPTONt MA. 01060
PERMIT VALIDATION
25C • 111 CODE # 79
DATE February 6. 19_80 PERMIT NO. 65
APPLICANT Pgtr4c48 W. Wdeland ADDRESS_46 Grant- Arne.
(NO.) (STREET) ICONTR'S LICENSE)
NUMBER OF
PERMIT TO WAAd-S#,GYa (�_) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE
ZONING
AT (LOCATiONI 46 Grant Avenue DISTRICT URB
(NO.) (STREET)
w BETWEEN AND
(CROSS STREET) (CROSS STREET)
w
n. LOT
m SUBDIVISION LOT BLOCK SIZE
a
U
O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
Z (TYPE)
C
OLL REMARKS: In's-11 wood—burying stove in AXi gt f,ng nh mney (flue lined)
AREA OR $
VOLUME ESTIMATED COST $ 500.00 FEEMIT 10.00
(CUBIC/SQUARE FEET)
OWNER RatelCla W. 114-aland & Ruth P-RAe OU9AVT.
ADDRESS —46 Grant Ave. , N'ton— BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)