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NOTES and Data — (Far department use)
G
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmet, city, anal State ZIP clde Tel. No.
1. f
Owner or •
Lessee
u i l e s ,2 '7—
L �� License No.
Contractor
�4
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.
Signaturepl�n`��Lc�ryL� / Address ApGplfica i�n ate
J(��JI�nJ,
D0 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plan Review Date Plans Date Plans
Plans Review Required Check Fee Started By Approved BY Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date ole
Permit or Approval Check Obtained 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
II. VALIDATION
Building / FOR DEPARTMENT USE ONLY
Permit number
Building- Use Group
Permit issued �41 �,9, i9 A
Building Fire Grading
Permit Fee $ Live Loading
Certificate of Occupancy $ Occupancy Load
Ap ed by: � t
Drain Tile $
Plan Review Fee $
l/
TITLE
CITY OF NORTHAMPTON
B* °� • MASSACHUSETTS
j OFFICE of the INSPECTOR of BUILDINGS
Page Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
jZONING
AT (LOCATION) DISTRICTuA�
LOCATION ' STREE
T'
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
H
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
-a
1 New building Residential Nonresidential
2 Addition(If residential, enter number 12 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
22 Service station, repair garage
5� Wrecking (11 multifamily residential, of units --► � P 9 9
enter number of units in building in 15 Garage � ) 23 Hospital, institutional
Part D, 13) 16
6 Moving (relocation) Carport ort 24 Office, bank, professional
�
17 Other — Specify 25 E] Public utility
7 Foundation only 26 School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 Private (individual, corporation,
26 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 $ s
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
30 Masonry (wall bearing) 40 Public or private company 48. Number of stories..............
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 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 Lj Gas Will there be central air 52. Outdoors........................
36 [_—] Oil conditioning?
_ L. RESIDENTIAL BUILDINGS ONLY
37 r Electricity 44 Yes 45 No
{� 53. Number of bedrooms..............
38I Coal
39 L� Other — Specify Will there be an elevator" Full..........
I� 54. Number of
46 [ a
I Yes 47 No bathrooms
Partial........
Department of Building Inspections
212 Main Stree&�,,, BUILDING '°
Northampton, Maj, 01060 as 1Q, �l
PERMIT y/
17A - 5$ VALIDATION
DATE _April 2. 19 82 PERMIT NO. 105
APPLICANT `(eral A Arcb—b-11 t ADDRESS 171 Wes t Sty _ (y�� HAt�fI el d _
(NO.) (STREE� (CONTR'S LICENSE)
NUMBER OF 1
PERMIT TO (1__) STORY DWELLING UNITS
( YP IMP OVEMENT) NO. PROPOSED E1
ZONING
AT (LOCATION) 197 Ar
DISTRICT 11�
(N0.) (STR T)
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
(TYPE)
REMARKS: Demolition of one car garage - no rebuilding a& this time - foundation to remain
AREA OR PERMIT
VOLUME ESTIMATED COST $ 100.00 FEE
(CUBIC/SQUARE FEET)
S
OWNER �L6b @a<k CaSbman
BUILD
ADDRESS 107 Bridge Rd., Northampton, Ma, 01060 — BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK ASSESSORS COPY