17C-077 (5) 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 building.
/7C - 7 7
Application for Permit to Build 4-,M 1P0 6 0
Northampton, Mass., .. ............Z......19?�.4..
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 .... . .» ...»��....,..»...._....................._..........»...............................».......................................
2. Owner's address
3. Architect's name
4. Builder's name
.........I...».....................................»............................».......................................
5. Builder's address
6. Location of Buildi
7. Is this a removal or new building.......................................".................»......._......................................................... .....................
8. If removal, from where ...........».».......»....».......... ................................................................................................................................
9. What is the purpose of building .................».........................................................................................................................................
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 ..... .........................................»................». ....»......._..:....................................................I
of
13. Size of building, of feet front �-
g, .....».».»..,.......;No. of feet deep��..-:............: 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....................»....a...................»....................
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 ......»»....»....»................... _.............».........»..........»........
30. Estimated cost (must be filled out) �-?�JU"�V
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.
Signature of applicant .....
' �No�5..::� ....................
REMARKS
.............................................»... » ... ....».........»....».»....».».......»...........................................................................................................I.....................»
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A.UNINU rcrilvil 1 r�-• 11�1) 1'0l Lot
APPLICATION
;oning"Ordinance Sectien 1.0.:' C F11c No0 hlryn file
,vner iCo$F 2i 44m, i--C
.ddress 21 Mr-tv Z7"
Addres.
'elephone S& `r- 93 S're Telephone -
Phis section is to be filled out -in accordance r;i t,h the "T=,b1-e of Dirmciision,,1. And
)ensit,y Re latione:. (Z.0. ARTICLE VI)
toning Tire hot Front Depth 0tbac1 i:ax.Z31d. Afin. Op.
ist ict Area `41dtII Fro n t Side ;;;r Cover. Space _
7V IV_� %
last Existing.
'res t Proposed �� %
lark the appropriate box. to 1ndicite the use of tllr rcrcel:
[] Non-Conforming Let :,rd/or "trLlCtUrC. Sl,ecify --.---.----------._..- ----
Residential CK Singje F.�,i,dl,y Unit. =Vulti-Fa^lily
[� Duplex 0 thei
�] Business
Q Industrial
D 2nstitutior,1.
Q Subdivision [� R, P.U.D.
_ 0 Subdivision with 'TA.hprov �l-Not Re7ttir, ci" ,:;t �rnp:
= Planning hoard Approv�.l.:
= Zoning Ao�ird Approval (Special Permit 10.0: V<-rinnce)
= city Council (Special Exception S. 10.101
Yes [� r'o
Satershed Protection District Over.lr.y: (Z.('. Sect. - ;IV)
Parking Space Requirements: (Z.O. ect. ,'.l) Required Proposed
Loading Space Requirements: - (Z.O.-- ect. 8.2) Required Proposed
- - -._.---------- � �
Signs: (Z.0. Art. VII) Yep rlo
Environmental Performancc. Standard:,: (Z.0, Art., XJ.I) Dyes Arlo
Plot Plan Yes r'o Site Plan Yes =,1`'e
(S. 10,.2) , (;. 10.2 and 10.11.
W-iver Gr,7ntec1: Dn to 0
Thir, section for OFFICIAL, use only:
=Approval as presented:
=Modifications necesc,�ry for c l?ra ov- 1:
O Return: (More informnt.ion needed)
Deniol: Re,arons:
1117
Signature of Apl�licart Date Si";n� re �.f A(lrnin. Officer hate
I hereby certify that the proposed work is authorized by the;.erww I of'
and I have been authorized by the .:owner to make.this.applicat-ion *s 'his
authorized agent. w'
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (S-TRU.T (CITY)
m
APPROVED BY TITLE
DATE 19
DEPT. FILE COPY
! 0
Z
oa
City of Northampton BUILDING
Massachusetts PERMIT
Office of the Inspector of Buildingx VALIDATION
^ 1
V ' DAT P 19 7( RMIT NO.-6P"
APPLICANT DRES 06 '
(NO.) Cj (STREET) (CONTR'S LICENSE)
,I NUMBER OF
PERMIT TO (_L_ ) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) DISTRICT /
(N0.) (STREET)
a BETWEEN AND
T
(CROSS STREET) (CROSS STREET)
LOT
(L SUBDIVISION LOT BLOCK SIZE
m
a
U
O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
f (TYPE)
X
O
REMARKS:
AREA OR �^� PERMIT $
VOLUME ESTIMATED COST [rte FEE
/SO E FEET)
OWNER w
BUILDI
ADDRESS BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)