17C-205 (8) Vill. ZONING PLAN EXAMINERS NOTES
SIDE YARD SIDE YARD
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants y l
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
1. �' /-';' ' - - - t!' /l�ii� ��/dam Shy/970
owner or
Lessee 2 / �+ �/� ✓y�f/J
2. / J �C ���/�- �' l[/. O I�Z%" Licenser 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 a icant Address Application date
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check
Plan Review Date Plans B Date Plans
Fee Started y Approved By Notes
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 L/ l
Building /` Use Group
Permit issued 19
Building Fire Grading
Permit Fee $ Live Loading
Certificate of Occupancy $ occupancy Load
Approved by:
Drain Tile $
2,L
Plan Review Fee $
LE
�s
CITY OF NORTHAMPTON
�. MASSACHUSETTS
$ f OFFICE of the INSPECTOR of BUILDINGS
Page Plot APP L I CATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. 0
.�, ZONING
��� j- DISTRIC
�/��T T
1• AT (LOCATION) �
LOCATION (NO') (STREET)
OF 8 E T W E E N /6_62ei� C-Ir- AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
H
11. 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
--f
1 ❑ New building Residential Nonresidential
2 ❑ Addition()/ residential, enter number 12 One family 18 ❑ Amusement, recreational
of new housing units added, if any, 13 ❑ Two or more family - Enter 19❑ Church, other religious
in Part D, 13) number of units- - - - i 20❑ Industrial
3� Alteration (See 2 above)
14 Transient hotel, motel,
4 ❑ Repair, replacement 21 Parking garage
p p or dormitory - Enter number
------ - 22 L� Service station, repair garage
_
5 ❑ Wrecking (if multi family 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 F Moving (relocation) 25 Public utility
17 ❑ P
Other - Specify ❑ y
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 D Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential - Describe in detail proposed use of buildings, e.g., food
6� processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,,,,,,,•,..... 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 C -
o. Electrical..................... yiA1
b. Plumbing ..................... //
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT 1$ Y
III. SELECTED CHARACTERISTICS OF BUIFILDING — 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 ❑ Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 ❑
Structural dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other - Specify 42 ❑ Public or private company 50. Total land ores, 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 C� Electricity 44 ❑ Yes 45 No
53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other - .Specify Will there be an elevators Full..........
— 54. Number of
46 Yes 47 ' No bathrooms
Partial......
City Of Northampton REQUIRED INSPECTIONS
1 . Footings and Walls
s
BUILDING DEPARTMENT 2 . Structural Components in
Place
3 . Complete Building
No. uQ Office of the Building Inspector
Date October 4, lg 89
BUI DING P RMIT
THIS MAY CERTIFY THAT Richard P. Dec Insp. on Site — Foundations
has permission to do alterations to ceate office space Insp. of Plumbing — Rough
situated on 63 Main St. , Florence 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
s 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 THE PREMISES
Certificate of Occupancy
Building Inspectdr
PH1 . P