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NOTES and Data — (For department use)
A
IV. IDENTIFICATION — To be completed by all applicants
Name Mo il i ng address — Number, street, city, and State ZIP code Tel. No.
Owner or
Lessee
Bu`ilder's
2• License No.
Contractor
3.
Architec 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.
Signature of applicant Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Plans B Notes
Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number By Permit or Approval Check Date Number B
Obtained Obtained 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 ' , 1 ' C Use Group
Permit issued 19
Building Fire Grading
Permit Fee $ Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
e OFFICE of the INSPECTOR of BUILDINGS
Page Plot—� APPLICATION FOR
a,�T
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. 0
,.+
ZONING
E/— DISTRICT
I• AT (LOCATION)
LOCATION ("O.) (STRE T) /
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 ;0
M
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
1 New building Residential Nonresidential
2 Addition(If residential, enter number 12 One family 18 Amusement, recreational
of new bousing units added, if any,
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 L Repair, replacement or dormitory — Fnter 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
17�� Other — Specify 24 Office, bank, professional
L�
6 Moving (relocation) 25 L Public utility
_
7 Foundation only 26 School, library, other educational
C_
B. OWNER I 27 Stores, mercantile
8 Private (individual, corporation, 28 L Tanks, towers
nonprofit institution, etc.) 29 Other Specify
9E] 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
school, secondary school, college, parochial school, parking garage for,
10. Cost of improvement•,•,,,,,•••....
department store, rental office building, office building of 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 $ �C
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
48. Number of stories................
30 D Masonry (wall bearing) 40 Public or private company
31 Wood frame 41 L 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 WATER SUPPLY
34 L Other — Specify 42 � Public or private company 50. Total land area, sq. ft. ..........
43 L Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 G a Will there be central air 52. Outdoors........................
36 Oil conditioning?
4-,< L. RESIDENTIAL BUILDINGS ONLY
37 C L
_� Electricity 44 ] Yes 45 53. Number of bedrooms..............
38 Coal
39 �� Other — Specify Will there be an elevator° Full..........
54. Number of
46 Yes 47 No bathrooms
�— Partial.......
'DEPT:OF BUILDING INSPECTIONS BUILDING '° j 1
212 Main Street O`
Northampton, MA 01060 PERMIT <a
11C - 21 VALIDATION
DATE Y 1 244
APPLICANT Joseph Sykier ADDRESS �1b 4IHiP yl,IT/IV O.
(NO.) (STREET) r(a (CONTR'3 LICENSE)
One Family NUMBER OF
PERMIT TO Alteration (_) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
5 Heffernan St. , Leeds ZONING
AT (LOCATION) DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
permit for the removal of single window and install double windov�TYPE,
REMARKS:
500.00 PERMIT 10.00
AREA OR
VOLUME ESTIMATED COST $ FEE
(CUBIC/SQUARE FEET)
Bradley & Carolyn Levay
OWNER BUII
ADDRESS
BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK ^ ASSESSORS COPY pjNT P