17B-014 (4) For ALL buildings within Fire District and for other buildings costing $10,000.00 or more,plans
and specifications must be submitted to the Inspector of Buildings for examination and approval.
If building is to be moved give details relative to proposed location as for a new buildin 15 ,,-, 1 I
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Application for Permit to Build
Northampton, Mass., ... � /..»........19»?.61.»..
To the Inspector of Buildings:—
The undersigned hereby applies for a permit to build, move, alter, or repair, according to the
following specifications.—
1. Owner's name ............ '��. ........... ......
I:!/.. ./�, �..... .........�../ .......J».,...........».......»......»........
2. Owner's address .».....»..L.. ........i/,�.r� ` ........, »!`. ....».J/1.. ........ .».,, �//e./...,.....� SS
3. Architect's name ............. ...............»..........................»...................................................................................................................
4. Builder's name ..................._......................_....».............................».....................,......_...................................................................................
5. Builder's address ............................................».............................._................... ........... ........................................»..........
. ................. .............
y-. dl G �cr �®rc�
6. Location of Building. Street No. ....................... .»........».». ................. ...... ................. ». ................».............».»....»».....».
7. Is this a removal or new building ....................... � �19.. ................................................................... , ............».....».
8. If removal, from where ...........».........»....»............................................................_...................................................................».................
9. What is the purpose of building . :"..5.` t ......................................._......................................................................................
10. Material of building ........................................»........................................................_.............,............................._.........................................
11. If a dwelling, for how many families ........................................».....Number of rooms ...................................................
12. Is there to be a store in the building .................................................»................».`....».......»..:.......»........................_...................
13. Size of building, No. of feet front ....4L�...........;No. of feet deep .....»f Cam_.....; No. of stories ..../._........
14. Size of ell, No. of feet front ........................: No. of feet deep ......................... No. of feet high ...........».............
15. Size of Lot ...........................................................».......................Feet Wide ................_................. Feet Deep ................................
16. How near the-line of street .............................»............................................,................................»..........................................................
17. How near the line adjoining lot. Right...................................; Left...................................; Rear................................
18. Nearest building is ................................ feet in a...................................................... direction ......................................................
19. Material of the floor.............................................................................................................................................................................
20. Size of timbers, 1st ......................; 2nd ....................... : 3rd ........................; 4th .............................; 5th ............................
21. No. of feet span...........».............».......................................... ; Distance on centers .....»............................................................»..
22. Will the building be erected on solid or filled land ............................._................................................................».............
23. What is the material of foundation .....»....»............................».......»....»........................................; Footing .......................
24. Will the roof be flat or pitched ...........».»....».......................................; Covering....................»..............................................
25. Heat; steam, hot water, furnace, stoves.........................................; Power oil burner ...............................................
26. Fireplace .....»................................................................; Insulation ...................................................................».........................................
27. How many sinks ............: Toilets ............; Lavatories .........; Bathtubs.......; Showers............; Settubs.........
28. City Service; Water ....................... Sewer ........................: Road Surface ..........................; Sidewalk ........................
29. Is lot on accepted street ..............»....».»...........1� ................. ...........................................................................................................
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30. Estimated cost (must be filled out) ......../. , !... ................».........................»............................_....».........................»..............
Applicant agrees to give the Inspector of Buildings 24 hours' notice before lathing or
plastering this building. This building will conform to the requirements of the law.
.....1..:�...GJL ! .... .»....».... ......................................... .................
Signature of applicant ........ ».� »
No.........L»� »...._...........
REMARKS
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