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NOTES and Data — (For department use)
�o4gttMtpTOy
w
1� �ASSAC�j11SttIS w '�1
� x
DEPARTMENT OF BUILDING INSPECTIONS
. INSPECTOR 212 Main Street ' Municipal Building y
Northampton, Mass. 01060
AS A HOMEOWNER I UNDERSTAND THAT I MAY APPLY FOR AND RECEIVE
A BUILDING PERMIT FOR A HOME OR ADDITION I INTEND TO LIVE IN.
I ALSO UNDERSTAND THAT I AM RESPONSIBLE FOR KNOWING THE STATE
BUILDING CODE AND ZONING ORDINANCE OF THE CITY OF NORTHAMPTON.
BEING A HOMEOWNER AND NOT A PROFESSIONAL CONTRACTOR IN NO WAY
ABSOLVES ME OF ANY RESPONSIBILITY TO INSURE THAT ALL FACETS
OF THE RULES AND REGULATIONS ARE COMPLIED WITH.
1 7
��
lie
IV. IDENTIFICATION To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or /El'L4�t
Lessee
Builder's yin 2. '-S 'C"4�/0 s, License N 0 3 41,6
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.
S'.9n,pture of,applica t Address
Applicotionn date
ir
76
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 Dote Plans
Plans Review Required Check Fee Started By Approved By Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL I$
OTHER I$
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
ate Date
Permit or Approval Check Obta D 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
Building Fire Grading
Permit Fee C Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile
Plan Review Fee 2
TITLE
CITY OF NORTHAMPTON
�. MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
�Plot 4
Page g � 1.- I APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
.~
I• AT (LOCATION) ( ,# '"/ i't` `t /� f DIOSTR
IC
LOCATION } (NO..) yl p ry I y t(SfTRyEET --/��y / y
OF BETWEEN ` i1 11f j L I l� 1 I Yi AND E! / ! l(✓f�.
BUILDING (CROSS STREET) (CROSS STREET)
°'7 LOT
SUBDIVISION LOT 6 BLOCK r SIZE dC
N
II. TYPE AND COST OF BUILDING — A11 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,XAddition(If residential, enter number 12><'One family 18 ❑ Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 Two or more family — Enter 19 Church, other religious
3 Alteration (See 2 above)
number of units— — — — —► 20 �� Industrial
❑ _
14 L❑ Transient hotel, motel, 21 C7 parking garage
4 ❑ Repair, replacement or dormitory — Fnter number
5 F-1 Wrecking (11 multifamily residential, of units ——————— — -� 22 L J Service station, repair garage
enter number of units in building in 15 ❑� Garage 23 Hospital, institutional
Part D, 13)
16 ort Car 24 Office, bank, professional
6 ❑ Moving (relocation) ❑ p
17 Other — Specify �/, •• j f r �';G 25 ❑ Public utility
7 L❑ Foundation only
26 C� School, library, other educational
r
B. OWNERSHIP /41:2 ' 27 Stores, mercantile
8XPrivate (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 ❑ Other — Specify
9 D 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,,,,,,,,,,,,,,,, t *~tix 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....................... 6L
b. Plumbing ....................... '' T
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 ❑ Masonry (wall bearing) 40X Public or private company 48. Number of stories..............
49. Total square Feet of floor orea 7?.
,r �J
31 Wood frame 41 ❑ Private (septic tank, etc.) "d a
all floors, based on exterior �* x.60
32 ❑ Structural steel dimensions ................./.��1
33 �❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other — Specify 42 �,7 Public or private company 50. Total land area, sq. ft. ........... 3 j d
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 ❑� Gas Will there be central air 52. Outdoors........................
36 Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 L j Electricity 44 ❑ Yes 45No 53. Number of bedrooms..............
38 �❑ Coal J '
39 L1 Other — Specify Will there be an elevators Full..........
- 54. Number of
46 �� Yes 47 No bathrooms Partial........ "" "°'
g 01"Ma 0 City of Northampton REQUIRED INSPECTIONS
1 . Footings and Walls
s
BUILDING DEPARTMENT 2 . Structural Components in
Place
3. Complete Building
No. R71 Office of the Building Inspector
Date December 13, 19 89
BUI DING P RMIT
THIS MAY CERTIFY THAT Charles A. Schmidt Insp. on Site — Foundations
has permission to constrct addition 576 sq. ft. onto existing Insp. of Plumbing — Rough
single family dwelling
situated on 703 Ryan Rd. Insp. of Plumbing — Finish
provided that the person accepting this permit shall in every re- Insp. of Wiring — Rough
spect conform to the terms of the application on file in this office,
and to the provisions of the Statutes and the Ordinances relating Insp. of Wiring — Finish
to the Construction, Maintenance and Inspection of Buildings in Insp. of Health (Septic Tanks)
the Citv of Northampton. Any violation of any of the terms above
noted is an immediate revocation of this permit. Expires six Building Insp. — Rough
months from date. Building Insp. — Finish
Note: A certificate of occupancy will be issued by this office upon
return of this card signed by the Plumbing, Wiring and Building Smoke Detectors (Fire Dept.)
Inspectors. Gas Inspection
'PHIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE THE PREMISES
Certificate of Occupancy
X Building Inspector �.
PRIN. T SNOP