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SIDE YARD SIDE YARD
Em
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NOTES and Data — (For department use)
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IV. IDENTIFICATION — To be completed by all applicants
Name II Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or :S-AN' TE6 O( I it o ST FLbRENCE HA 1610(po
Lessee
2. AM C I)V Builder'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 is ap ccytion as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Sign re of a I'c Address Application date
RLOR 4-/\) 10
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans B Notes
9 Fee Started Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER Is
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 �Z
Building
Permit issued 1y <� fq Use Group
Building �� Fire Grading
Permit Fee $ Z
Live Loading
Certificate of Occupancy $ Occupancy Load
$ APPrY• , -
f'
Drain Tile
Plan Review Fee $ °�
T E
CITY OF NORTHAMPTON
MASSACHUSETTS
• a
$ a OFFICE of the INSPECTOR of BUILDINGS
T
Page t � Plot 7--53- APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 1I C)
/it, IV, and IX.
ZONING
• AT (LOCATION) • OAK 15T-. t40 `15 "y C e�- I "/iA D STR CT_URS4�)
LOCATION (NO.) (STREET'
OF B� b fit!EL.L. AVC-- OR I D 6�
BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT S a o
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 rn
rn
1 F-1 New building Residential Nonresidential
2 Addition(If residential, enter number 12X One family 18 Amusement, recreational
of net, 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) r
14 Transient hotel, motel, 21 I Parking garage
4 Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (If 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 C7 Carport 24 Office, bank, professional
6 Moving (relocation) 17 E] 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•,,•••••,....... C) 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....................... o o
b. Plumbing ....................... b O
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $ ( Sa o
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 l i Private (septic tank, etc.) 49. Total square feet floor area,
all floors, bored 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 Gas Will there be central air 52. Outdoors........................
36 n Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 �J Electricity 44 [_ _] Yes 45 No 53. Number of bedrooms..............
38 Coal
39 Other — Specify Will there be an elevator? Full..........
— 54. Number of
46 Yes 47 D No bathrooms Partial........
City of Northampton REQUIRED INSPECTIONS
1 . Footings and Walls
BUILDING DEPARTMENT 2 Placetural Components in
3. Complete Building ,
No. 742 Office of the Building Inspector
Date 10-11-89 19
BU11 DING P RMIT
THIS MAY CERTIFY THAT Jan Stenson Insp. on Site — Foundations
has permission to renovate garage space Insp. of Plumbing — Rough
situated on 111 Oak 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
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 a"'
Building Inspector
PR