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NOTES and Data — (For department use)
CITY OF NORTHAMPTON
�• MASSACHUSETTS
$ e OFFICE of the INSPECTOR of BUILDINGS
Page 5 Plot ?-At APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT - Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING
I• AT (LOCATION) (d 1941pybr /i� �F/=�Si DISTRICT
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 -�
X
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
M
1 Ne uiIding Residential Nonresidential
2 Addition(If residential, enter number 12 V�e 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 l
l
t
h
i
Transent hotel, mote ,
❑ 21 Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (11 multi family residential, of units ——————— — --)... 22 Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 Hospital, institutional
P art D, ]3) 24 Office, bank, professional
6 ❑ Moving (relocation) 16 ❑ Carport �_�
7 ❑ Foundation only 17 ❑ Other — Specify 25 ❑ Public utility
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8 I Private (individual, corporation, 28 ❑ Tonks, 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,,,,•,,,•,,,,,,, % We school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office building at industrial plant.
7'o 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 $ �
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 L__J 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 /7V
..................... .
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 ❑ Gas Will there be central air 52. Outdoors........................
36 Oil conditioning?
�
� L. RESIDENTIAL BUILDINGS ONLY
_
37 Electricity 44 r Yes 45 k_ No
— 53. Number of bedrooms..............
38 ❑ Coal
39 Other — Specify Will there be an elevator
Full..........
__ 54. Number of
46 � Yes 47 ;I No bathrooms
Partial.......
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
1.
DWnG( of
Lessee
�� G ��S Builder'
2. License Ns
/ o.
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 Address Application date
-1— zl��Zfz
00 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
ate Date
Permit or Approval Check ObDtai ed 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 �3 1 FOR DEPARTMENT USE ONLY
Permit number
Building J Use Group
Permit issued S7 Z�p 19�
Building yp Fire Grading
Permit Fee $ Live Loading
Certificate of Occupancy $ Occupancy Load
&D=ed by:
Drain Tile
Plan Review Fee
y/ TITL
City of Northampton REQUIRED INSPECTIONS
1 . Footings and Walls
BUILDING DEPARTMENT 2 . Structural Components in
Place
3 . Complete Building
No. 539 Office of the Building Inspector
Date July 26 , 1989 19
BUI DING P RMIT
THIS MAY CERTIFY THAT Stanley Sadowski Insp. on Site — Foundations
has permission to construct 1 40 sq. f t . of si denti al spacjnsp. of Plumbing --Rough
situated on 264 Audubon Rd. 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
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 T PREMISES
Certificate of Occupancy
Building Inspector
P INOP