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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.
� s
Owner or
Lessee
64/v` Builder's o.L. icense N
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.
Signat f applicant ! Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date P y Ions B Date Plans By Notes
Fee Started 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
Bui(ding• r
Use Group
Permit issued 19
Building q / Fire Grading
Permit Fee _- �[�.✓,/ // � Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
LE
o CITY OF NORTHAMPTON
�. MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR - BUILDING PERMIT
z
IMPORTANT •- Applicant to {co/m/Jplett�,ee all items in sections: 1, 11, 111, IV, and IX. O
ZONING
I• AT (LOCATION) r ^' //,/r/'" r• �/0
DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
to
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 E] 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 ❑ Transient hotel, motel, 21 ❑ 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 C❑ 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
B N7/ Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 2Q�- — SpeciJx
9 ❑ Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential — Describe in detail proposed use of bui dings, e.g., food
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement•,,••••••....... i d 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 ....................
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $ coo
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 X] 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 f GQ C)
32 ❑ Structural steel dimensions ..................... / Q
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 [_ Yes 45 � No 53. Number of bedrooms..............
38 ❑ Coal
39 [71 Other — Specify Will there be an elevator? Full..........
54. Number of
46 ❑ Yes 47 X No bathrooms
Partial......
Depart at A Building Inspections
212 Main Street BUILDING °
Z
Northampton, Ma. 01060 $IL ��
PERMIT
17C - 196 VALIDATION
DATE December 28. 19 82 PERMIT NO. 695
APPLICANT Stanley J- Sawicki ADDRESS 569 River side Drive 010263
(NO.) (STREET) (CONTR•S LICENSE)
NUMBER OF
PERMIT TO Al tarAtinn ( I STORY weldiI SI r _DWELLING UNITS -»
(TYPE OF IMPROVEMENT) NO. IP POSEO QSE)
ZONING ��
AT (LOCATION) 45D Nan Sty v F1nrpfnrp DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: Tnctall 7 OArAba Aoj0r¢ walk in TeAr floor, Mf-a '• A1t4rAt4nnft
AREA VOLUME ESTIMATED COST $�T nn FEEMIT � QQ
•
(CUBIC/SQUARE FEET)
OWNER Cenp i a> ren BUILDING PTB
ADDRESS On main Street Eloren__�_ce Ma- 01060 BY
WHITE - FILE COPY • GREEN ^ FIELD COPY CANARY - APPLICANT COPY • PINK - ASSESSORS COPY