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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, anci State ZIP code Tef No.
Owner or t� � t }
Lessee
2. f
Builder's
L
r� icense 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 appl can Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approva I Check Date Number B Permit or Approval I Check Date Number B
Obtained y pP 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
Bui Iding. Use Group
Permit issued fq ;�a_
Building Fire Grading
Permit Fee $ f/J /1d
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $ , ^
TI
*gyp * CITY OF NORTHAMPTON
MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
,V, Page Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, II, 111, IV, and IX. 0
ZONjG1 DIST
I• AT (LOCATION) -`'� - -_-
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 ;o
M
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
1 ❑ New building Rential Nonresidential
2 ❑� Addition(If residential, enter number 12 LYOne 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- - - - -i 20 ❑ Industrial
3 Alteration (See 2 above) 14 Transient hotel, motel,
y�4 ❑ 21 ❑� Parking garage
4 ❑ Repair, replacement or dormitory - Enter number
5 ❑ Wrecking (11 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 24❑ Office, bank, professional
6 ❑ Moving (relocation) 25 ❑ Public utility
17❑ Other - Specify
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
28 Tanks, towers
8 Private (individual, corporation, ❑
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................
Fj 7 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 xisting building is being changed, enter proposed use.
in the above cost y
a. Electrical......................
b. Plumbing .......................
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT I$
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) ^`+��` p p y 48. Number of stories..
ubhc or rivate com an
31 Wood frame 4�Private (septic tank, etc.) 49. Total square Feet floor area,
\ all floors, based on n 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 I/Y Gas Will there be central air 52. Outdoors........................
36 Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 r7 Electricity 44 ❑ Yes 45�No 53. Number of bedrooms.............
38 �❑ Coal
39 �❑ Other - Specify Will there be an elevator? 54. Number of Full..........
-
bathrooms
46 ❑ Yes 47 o Partial........
1 As.--
INSPECTION RECORD
DATE NOTE PROGRESS - CRITICISMS AND REMARKS INSPECTOR
)
FIELD COPY
DEPARTNUT OF BUILDING INSPECTIONS
�-fL2 MAIN STREET BUILDING
NORTHAI FMq MA. 01060 PERMIT
1
1.7A - 379
DATE 9"tember 28, 19 80 PERMIT NO. 496
APPLICANT Kenneth B. Nuttelmu ADDRESS 63 Oak Street* Floremee
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO Alteration ( NUMBER OF
STORY DO'L"QtEr DWELLING UNITS �.
(TYPE OF IMPROVEMENT) NO, (PROPOSED USE)
AT (LOCATION) 63 Oak ZONING
DISTRICT Un 1
IN 0.) (STREET)
rn BETWEEN AND
a (CROSS STREET) (CROSS STREET)
D. LOT
m SUBDIVISION LOT BLOCK SIZE
a
O
O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
r0
O
j Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: Add_5 oymm►r 8 X ib
1
I
' AREA OR PERMIT j
j VOLUME ESTIMATED COST . _ 850-00 FEE $ 10-00
(CUBIC/SQUARE FEET)
OWNER Kamleth ,R• muttelf1Um BU LIII DEPT /e
ADDRESS 61 Oak Stzeet, Flor4mce, MaN 01060 BI