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YIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN For Applicant
....
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name t. t) Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or
Lessee pp �\� 1/ �� �q. —�
2. �t1� � � Q �V` (r/ L s� Builder's
��/ License No.
Contractor
do
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 authori ed agent and we agree to conform to all applicable laws of this jurisdiction.
Signature of licant Address Appli atio/date
iC
9 c <
0
0 NOT WRITE BELOW HIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL Is
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number By Permit or Approval Check Date Number Obtained Obtained b 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
Permit number `� �\./ FOR DEPARTMENT USE ONLY
Building Use Group
Permit issued 19
Building -� �. Fire Grading
Permit Fee
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee
f
� — �_'
:� ,,� TITLED
CITY OF NORTHAMPTON
�. P MASSACHUSETTS
t OFFICE of the INSPECTOR of BUILDINGS
aT
Page Plot /� APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to.J�complete all items in sections: 1, 11, 1//,y, IV, and II�(�X. O ZONING
I• AT (LOCATION) ✓� `" c�' . '•r 4 D STR CT 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 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— — — — --1. 20 C] 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 F-1 Wrecking (1l multifamily residential, of units ——————— — --•>
❑
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 — SpeciJy 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
W processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement•,•.......•••••. U Cr-tl 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 ..................... f1..
c. Heating, air conditioning..........
d. Other (elevator, etc.)............. c� r
11. TOTAL COST OF IMPROVEMENT $
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 fl
30❑ Masonry (wall bearing) 40 ❑Public or private company 48. Number of stories............... r
49
31 Wood frame 41 ❑ Private (septic tank, etc.) . Total square feet floor area,
all floors, based on exterior �C}✓}
32 ❑ Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 El Other — Speci/v 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 [F11 0 i I conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 [—] Yes 45 N No
53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other— SpeciJy Will there be an elevator? Full..........
r _ 54. Number of
46 l ) Yes 47 � No bathrooms
Partial........
O�'CttM1P�0 City of Northampton REQUIRED INSPECTIONS /
1 . Footings and Walls
BUILDINGDEPARTMENT 2 - Structural Components in
Place
3 . Complete Building
No. -420- Office of the Building Inspector
Date July 16, 1990
BUI DING P RMI
THIS MAY CERTIFY THAT Phaneuf Construction Insp. on Site — Foundations
has permission to 392sg. ft. addtion - Laundry & den Insp. of Plumbing — Rough
situated on 123 Audubon Rd. , Leeds 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.
Note: A certificate of occupancy will be issued by this office upon Building Insp. — Finish
return of this card signed by the Plumbing, Wiring and Building Smoke Detectors (Fire Dept.)
Inspectors. GJas Inspection
THIS CARD MUST BE DISPLAYED IN A CONSPIC" PLAC =HE PREMISES
Certificate of Occupancy -
,nspector
P WP
5
City of NortlYain Zola REQUIRED INSPECTIONS
pion
. Footings and Walls
BUILDING DEPARTMENT 2 Placetural Components in
3 . Complete Building
No. Office of the Building Inspector
Date 19
BUI DING P RMIT
THIS MAY CERTIFY THAT J Insp. on Site — Foundations
has permission to Insp. of Plumbing — Rough0/< �'- 9�
situated on Insp. of Plumbing — Finish
provided that the person accepting this permit shall in every re- Insp. of Wiring — Rough z ur
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 04M
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 q
months from date. Building Insp. — Finish
Note: A certificate of occupancy will be issued by this office upon
return of this card signed by the Plumbing, Wiring and Building Smoke Detectors (Fire Dept.)
Inspectors. Gas Inspection
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON THE PREMISES
Certificate of Occupancy
Building Inspector
P 01-10 P