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NOTES and Data — (For department use)
C)+ 4c)
IV. IDENTIFICATION - To be completed by all applicants A
Name Mailing address — Number, strec°t, city, and State ZIP code TeI PN
Owner or
Lessee 0160
Builder's
2 Barve- 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.
Signs a of applicant Address Application date
r, "<.
'�`1 C I rr
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re wired Check Plan Review Date Plans B Date Plans B Notes
9 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL Is
OTHER Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Obtaatned Number By Permit or Approval Check Obttat 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
I1. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building. p� Use Group
Permit issued _ L 19 RI —
Bui Iding � / Fire Grading
Permit Fee $ _ llp•®0
Live Loading
Certificate of Occupancy $ Occupancy Load
Aadd byDrain Tile $
Plan Review Fee $
TITLE
�o CITY OF NORTHAMPTON
MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page 4 Plot
APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
Ca h I CG-n e, �l�l �+ ZONING
I• AT (LOCATION) i DISTRICT�\
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
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
2X Addition(If residential, enter number 12 [_1 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
number of units-- - - - -� 20 �❑ Industrial
3 ❑ Alteration (.See 2 above) 14 Transient hotel, motel,
❑ 21 ❑ Parking garage
4 �❑ Repair, replacement or dormitory - Enter number
5 ❑ Wrecking ([/ 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 L] Moving (relocation) 17 Other S p eci f WJ� p�Q� 25 ❑ Public utility
� - v 5 Y
7 ❑ Foundation only Nod 26 ❑ School, library, other educational
B. OWNERSHIP I t fl' 27 ❑ Stores, mercontile
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,,•,,••,,,,•,•,• , CX� 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....................... CID
b. Plumbing .....................
c. Heating, air conditioning........
d. Other (elevator, etc.)............. NONE
11. TOTAL COST OF IMPROVEMENT 24V t ezc
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 DISPQ /� J. DIMENSIONS OMD
14 WE 48. Number of stories................ LEVCL-
30 ❑ Masonry (wall bearing) 40 ❑ Public or private company
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 E❑ Other - Specify 42 Public 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 Gas Will there be central air 52. Outdoors........................
36 [ Oil xlo � conditioning?
L. RESIDENTIAL BUILDINGS ONLY
��
37 i I Electricity 44 l l Yes 45 jXNio 53. Number of bedrooms..............
38 I J Coal
F-1 Specify ci Will there be an elevator?
39 L_ 1 Other - ( Jy Full..........
54. Number of
46 C ) Yes -47 X Nlo bathrooms
Partial.......
_. ._._, .....�.,. . ...., _... . ._. �._.w.._.. ._.���.. _�� ___7.x .�_ ,... � ..
m . .-- ��a� _-- ��.,,.�.,,.��� .�.. ,.,.,�,,« � .�_.
OEPAR T OF �UTLDIxc 1NSPECTIM-TS BUILDING
212 A00 STREET PERMIT
NORTH Olt, 14A. 01060
VALIDATION
JF
28 « Gb l u
`DATE _� 'L�f_�� 19 At PERMIT NO.
APPLICANT Rar tel 1 s P,fAnlSA■ �. ADDRESS_I'Afin Ajar► Sty_ Springfield
(NO.) (STR EET� (CONTk'S LICENSE)
NUMBER OF
PERMIT TO �$� + (_) 'STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. PROP SED USE
ZONING
AT (LOCATION) " ..P ° DISTRICT Ell
.. (NO.) (MTREET)
BETWEEN " ND
(CROSS S REET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE YT. WIDE BY _ FT. IN HEIGHT AND SHALL.CONFORM IN CONSTRUCTION
TO TYPE:. USE GROUP BASEMENT WALLS OR FOUNDATION
' (TYPE)
R E M A R 2 T11.a_. A U 3a.$,rr:�A E34^4--T-9n—g pool_ �I„A�X 'Aa fmatAll 4* fence aCJ1rid area
VOLUME ESTIMATED COST $ _56300- � FEEMIT to w oo
(CUBIC/SQUARE FEET)
OWNER Doug 1? -- BUI I
ADDRESS t a}>3 i l Ann Tas a tA[un_ '11'1 ra i»s►ti�ea_ M.a;* 01060_ BY
WHITE - FILE COPY GREEN ^ FIELD` COPY CANARY - APPLICANT COPY PINK A ESSORS COPY