17A-223 (7) ZONING •
DISTRICT
SIDE YARD SIDE YARD
REAR YARD
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants _
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or Ztll f LL E & IZC� 6 7 ''1, 9 Z� tJ1>45
Lessee
' ,� ��.� 16 Builder's
2 '!
C. �C. �t;"s� � �. 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
make this application as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature of applicant j/A,ddress Application dote
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans By Notes
Fee Started y Approved
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 Use Group
Permit issued � � x 19 C _
Building ' Fire Grading
Permit Fee $ '?)(0'
Live Loading
Certificate of Occupancy $ Occupancy Load
$ Appkoved by:
Drain Tile
Plan Review Fee
v
TITLE
CITY OF NORTHAMPTON
.� MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page�7� Plot ���
�t APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORT/ANT — Applicant to complete all items in sections: 1, 11,, 111111, IV, and IX. 0
ONING
I• AT (LOCATION) / !'F ` !mot ��- �! ! GE C �L`'�'," " DIISTR CT
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
11. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use rn
rn
1 ❑ New building Residential Nonresidential
2 ❑ Addition(If residential, enter number 12 One family 18 ❑ Amusement, recreational
of new housing units added, if any, 13 Two or more family - Enter 19 Church, other religious
in Part D, 13)
number of units- - - - -_)� 20 Industrial
3 Alteration (See 2 above)
14 Transient hotel, motel,
4❑ Repair, replacement or dormitor y - 21 C] Parking garage
F.nter number r
5 ❑ Wrecking (If multi family residential, of Units ------- - i 22 L� 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)
17 ❑� Other - Specify 25 ❑ Public utility
7 ❑] Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP 27❑ Stores, mercantile
8 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 �/' ifx
a. Electrical..................... t on r r7 t
b. Plumbing q�u.G�' �l
c. Heating, air conditioning..........
d. Other (elevator, etc.)............. '
11. TOTAL COST OF IMPROVEMENT $ (d i ("Ll
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......... C
31 Wood frame 41 I❑ 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
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 ❑ Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 o
❑ Yes 45 N_- 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other - .Specify Will there be an elevators Full..........
- 54. Number of
46 1 Yes 47 I❑ No bathrooms
Partial.......
12.$ City of Northampton REQUIRED INSPECTIONS
$ 1 . Footings and Walls
{ BUILDING DEPARTMENT 2 . Structural Components in
Place
3 . Complete Building
No. -216- Office of the Building Inspector
Date Ap:il 24, 1990
BUI DING P RMI
THIS MAY CERTIFY THAT ' ' Insp. on Site — Foundations
has permission to Rail 2txi floor lath with rKw laA-&y ad ins al . 2 Insp. of Plumbing — Rough
situated on 194 North ftk St. Insp. of Plumbing — Finish
provided that the person accepting this permit shall in every re- Insp. of Wiring — Rough
spect conform to the terms of the application on file in this office,
and to the provisions of the Statutes and the Ordinances relating Insp. of Wiring — Finish
to the Construction, Maintenance and Inspection of Buildings in Insp. of Health (Septic Tanks)
the City of Northampton. Any violation of any of the terms above
noted is an immediate revocation of this permit. Expires six Building Insp. — Rough
months from date. Building Insp. — Finish
Note: A certificate of occupancy will be issued by this office upon Smoke Detectors (Fire Dept.)
return of this card signed by the Plumbing, Wiring and Building
Inspectors. Gas Inspection
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON THE PREMISES
Certificate of Occupancy
Building Inspector
PNINTRSNOP
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