25C-235 (5) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD ,� �� , _._ SIDE YARD
REAR YARD
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NOTES
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.
Owner or Z—
Lessee
Builder's
2. 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 applicati-jon avhis authorized agent and we agree to conform to all applicable laws of this jurisdiction.
- -
Signature of applicant Address TApplicption date
Q
0 0 NOT W R I T E BELOW T H I S L I N E
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
ate ate
Permit or Approval Check ObtDa ined 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 FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued 19 Pzl
Building Fire Grading
Permit Fee $ Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee
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NOTES and Data — (For department use)
y
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 fjAN EXAMINATION AND
BUILDING PERMIT
IMPORTANT - Applicant to complete all items in sections: 1, It, 111, IV, and IX. O
ZONING
I• AT (LOCATION) AF `7 ��+ �Di DISTRICT
LOCATION (NOJ (STRE )
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
V1
II. TYPE AND COST OF BUILDING - All applicants complete Parts A - D -a
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
M
1 ❑ New building Residential Nonresidential
24 Addition(If residential, enter number 12 ❑ One family 18 ❑ Amusement, recreational
of new housing units added, if any,
13 Two or more famil y religious
- Enter { 19 ❑ Church, other re
in Part D, 13) J �-:-- g
number of units-ransen - - - �— 20 ❑ Industrial
14 T
3'21 Alteration (See 2 above) it hotel, motel,
❑ 21 ❑ Parking garage
4 'Repair, replacement or dormitory - Enter number
5 ❑ 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)
6 ❑ Moving (relocation) 16 ❑ Carport 24�
, Office, bank, professional
7 ❑ Foundation only 17 F-1 Other - Specify 25 ❑ Public utility
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8 Private (individual, corporation, 28 ❑ Tanks, towers
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
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement................ �'! school, secondary school, college, parochial school, parking garage for,
epartment 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 / y //
a. Electrical..................... ° �L. '1 / E
b. Plumbing ..................... f
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
30 Z Masonry (wall bearing) 40�A Public or private company Number of stories......
Total square feet of floor area,
31 Wood frame 41 ❑ Private (septic tank, etc.) 49. all floors, based on ex e
32 ❑ Structural steel dimensions ......... .�j :�...
33 ❑ Reinforced concrete H. TYP OF WATER SUPPLY
..........
50. Total land ores, sq. ft.
34 F-1 Other - Specify 42 Public or private company
.
43 Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ......................
35❑ Gas Will there be central air 52. Outdoors.............1_ .......
36 Oil conditioning?
L. RESIDENTIAL BUILDIN S ONLY
Electricity 44 ❑ Yes 45j?l No 53. Number of bedrooms. Cam !
38 ❑ Coal
39❑ Other - Specify Will there be an elevator? Full., .....
54. Number of
46 ❑ Yes 47 VNo bathrooms
Partial.......
I 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 Kiss
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (Cl TY)
APPROVED BY TITLE
DATE 19
DEPARTMENT OF BUILDING INSPECTIONS DEPT. FILE COPY
zo
NOR TON STREET 01060 BUILDING �a
■ ERMIT VALIDATION
25C 234
DATE June 24. 19 80 PERMIT NO. 326
APPLICANT Frank T nurence _ ADDRESS
(NO.) STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO (47) STORY apartment DWELLING UNITS 4
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) 183 Bx4d DISTRICT
(NO.) ( TREET)
a BETWEEN AND
�o (CROSS STREET) (CROSS STREET)
a
LOT
CL SUBDIVISION LOT BLOCK SIZE
p Add�P11ro BE 10 FT. WIDE BY 16 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION.
M
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
E
K
O
LL REMARKS:
AREA OR ESTIMATED COST $ 59000 FEEMIT 15.00
VOLUME
(C DARE FEET)
OWNER rank T) & A1skncchP Ko T awrefl A BUILDIN DE T.1
ADDRESS . 1A� AridOP StYLII? Nnrthant�s Ma, 01060 BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)