17C-088 (8) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
1
FRONT YARD
I
SIDE YARD — SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
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BOCA FORM APEBP — 669 C1969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and Stag ZIP code , Tel. No.
� Gwts've�
Owner or _ �I L
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
mak t is application as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Srgna a of applicant / Address Application date
D0 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
q Fee Started y Approved y
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL Is
OTHER Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obta ned 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 �� j..- Use Group
Permit issued 19 ]f
Building
Fire Grading
�Permit Fee $�/ � Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile
Plan Review Fee
`TI
V
NOTES and Data — (For department use)
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 PLAN EXAMINATION AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. 0
I• AT (LOCATION) I U., /t.�`r 1111 s\j ` D S TR�C(. )
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
2 ❑ Addition(If residential, enter number 12F] One family 18 E] Amusement, recreational
of new housing units added, if any, 13 F-1 Two or more family — Enter 19 ❑ Church, other religious
in Part D, 13)
3 ❑ Alteration (See 2 above)
number of units— — — — --)P. 20❑ Industrial
14 ❑ Transient 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) ❑
16 Carport 24 ❑ Office, bank, professional
6 ❑ Moving (relocation)
7 ❑ Foundation only 17 ❑ Other — Specify 25 ❑ Public utility
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8 7K 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,
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.....................
b. Plumbing .....................
c. Heating, air conditioning..........
d. Other(elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT 1$
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 1V.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS i
30❑ Masonry(wall bearing) 40 Public or private company 48• Number of stories..... .........
31_Z Wood frome 41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area,,._.,
all floors, based o terior
32❑ Structural steel dimensions ....
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34❑ Other — Specify 420 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........................
conditioning?
36'� Oil L. RESIDENTIAL BUILDS ONLY?
37❑ Electricity 44 ❑ Yes 45� No 53. Number of bedrooms
38 ❑ Coo I
39❑ Other — Specify Will there be an elevator? Full..........
54. Number of
46 ❑ Yes 47 �4 No bathrooms
Partial.......
A'iM 4111r�8 4*jW,r y
hereby certify that the,;proposed -work is authorized by, ;
and 1 have been authorized by the owner to make this app i cation-as is—
authorized agent.
SIGNATURE OF CAGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
. I
DEPT. FILE COPY
Z
0
w�..e BUILDING fa
N11�WM SI Mi 17C 88 PERMIT VALIDATION
DATE October 10, 19 7_ PERMIT NO. 475
APPLICANT Norman Thielemann ADDRESS 1o6 Chestnut 8t_ Flo_
(N0.) (STREET) (CONTR'S LICENSE)
PERMIT TO Alter Residence (?) STORY Residence DWELLRING UNITS 1
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 106 Chestnut ZONING
DISTRICT
(NO.) (STREET)
a BETWEEN AND
a
(CROSS STREET) (CROSS STREET)
a LOT
m SUBDIVISION LOT BLOCK SIZE
a
0 BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
M
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
I
C (TYPE)
a REMARKS: E14minatca nTiA dnnr And add window, add Ater cA Rhed to Aida of hniiaa, Add
windows to back porch.
AREA VOLUME ESTIMATED COST FEEMIT $ 10_00
(CUBIC/SQUARE FEET)
OWNER Normm & Carol 23-ldamann !
BUIL ING T
ADDRESS 106 chestnut st e _t-1 VI nren(P(A, Ma= BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)