17C-222 (14) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
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BOCA FORM APEBP — 669 01969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
IV. IDENTIFICATION — To be completed by all applicants
T Name Mailing address — Number, street, city, and State ZIP code Tel. No.
. �. N N C
Owner or
Lessee
Bui Ider's
2.
License No.
Contractor 5 /S
* tI
3. G
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
f. ( Pros 3 6� Ina ow ,Au-s-(
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or A rova I Check Date Number B Permit or Approval I Check Date Number B
Pp 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 19.G —
Fire Grading
Building
Permit Fee $ Live Loading
Occupancy Load
Certificate of Occupancy
A pea by:Drain T i l e $
Plan Review Fee
TITLE
NOTES and Data — (For department use)
�►�1 A Ic c- ��o&P m
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 PLAN EXAMINATION AND
/,'7C — Z_2___?,- BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O
/" ZONING
AT (LOCATION) DISTRIC T
(• Z
LOCATION (NO') C_ (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
V1
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
1 ❑ New building Residential Nonresidential
2 ba Addition(If residential, enter number 12❑ 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
Transient hotel, mote ,
❑ 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory - Enter number
units ------- - 22 ❑ Service station, repair garage
o
5 ❑ Wrecking (If multifamily residential, J
enter number of units in building in 15 ❑ Garage 23 ❑ 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 A6 �� r 27 ❑ Stores, mercantile
8 ❑ Private (individual, corporation, y 28 ❑ Tanks, towers P
nonprofit institution, etc.) 29 ❑ Other - Specify • 1ZZ
9 ❑ Public (Federal, State, or dill Of
local government)
C. COST (Omit cent) Nonresidential - Describe in detail proposed use of buildings, e.g., food
/�/y V- processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,,,,,,,,,,,,,, 5V✓ . 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..................... e94,,JA"1 f£ 4 •Q is
b. Plumbing ..................... Sto IL;
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
3 48. Number of stories...............
0 Masonry (wall bearing) 40 Public or private company
31 ❑ Wood frame 41 ❑ Private (septic tank, etc.) �• Total square feet floor area,
all floors, based on exterior
32❑ Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 F-1 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 ❑ Yes 45 ❑ No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other - Specify Will there be an elevator? 54. Number of Full..........
46 ❑ Yes 47❑ No bathrooms
Partial.......
hereby certify that the-proposed work is authorized by the owner of record
and I have been authorized by the owner to make this application as his
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
DEPT. FILE COPY
BUILDING
/ PERMIT VALIDATION IC
DATE 19�- P E R MAZ J.N o
APPLICANT L/�_, ADDRESS
(NO.)- (STREET) (CONTR'S LICENSE)
�.► NUMBER OF
PERMIT TO Z!�� �" (_) STORY DWELLING UNITS
(TYPE OF IMPRO ENT) N0. (PROPOSED USE)
ZONING
AT (LOCATION) t!JA4�Aj DISTRICT
(NO.) (STREET)
m BETWEEN AND
�o (CROSS STREET) (CROSS STREET)
a
LOT
D' SUBDIVISION LOT BLOCK SIZE
m
6
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
m
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
0:
O
LL REMARKS:
ER
AREA OR o c FEEMIT
S
VOLUME ESTIMATED COST . s
(CUBIC/5 RE FEET)
OWNER BUILDING DE
ADDRESS BY
1
(Affidavit on reverse side of application to be completed by authorized agent of owner)
2-12-
Cp
j
og`� �0
No......»..........................»»»»...»..»»»»....
r
Erection..................._......(k)
" Alteration......................( )
Plans must be filed with the Building Inspector,
Repair.............................( )
Repainting....................( )
before a permit will be granted,
Ti -of A ort4amptan, Mass.
Application for a Permit to Place or Maintain a Sign
or other Advertising Device
(Application to be filled out in ink or typewritten)
FEE.......... PAGE../../.`.. PLOT.:....
[ / Northampton, Mass.,. z.: .....�.1 ............19...E
To the Building Commissioner:
Application for a permit to place or maintain�as sign or other advertising device, or marquee.
. ..... :cGc��I.....T,z`:" �. C :�..
BUSINESS NAME.....
......^ .
1. LOCATION, STREET and No. .......!.yS......L . :............ * .............�:.��:: .... ,.........................................,
2. Owner's name.....................:..........:....N..:.........;L.-.1s.....................................................................................................................................
3. Owner's address................... ,.......S.i............: 5:.� -�....:.............................................................................
...............
4. Maker's name....................19.4&i ' ... ..:..�,� �5,� .....................................................................................................
5. Maker's address.................... ,...../................( ve ;e � �: ............ �a........ �...1 �.. .. 7..............
6. Erector's name......................' ��� e: :c?.....(........... ................................................................................................
7. Erector's address..................................... .....................................................................................................................................
SIGN KIND OF SIGN
(Designate)
1. Sign will be (check one) illuminated..................non-illu fminated..................
2. Will sign obstruct a fire escape,window or doors .1.�!.Q..... Marquee.......................................
.... .
3. Lower edge will be......cf...::.... ft...................ins. above the public way. Proj ecting..........................
4. Upper edge will be.....
U..***".ft. ins. above the public way. Roof.................................................
.. .................
5. Height.....�:......ft.......(_?.......ins. Width.........q....ft...................ins.
Temporary.................................
6. Face area..2,.:.X....sq. ft. Wall.....'74...................................
7. Inner edge will be....C9.........ins from the building or pole. h 0, U,Q Ground..........................................
8. Outer edge will be..�..........ins.from the building or pole. Other..............................................
9. Face of building or pole is..................ins.back from the street line.
10. Sign will project...2........ins.beyond the street line.
11. Sign will extend....-=.—. ... .ft.....�-..........ins.above the building or pole.
12. Of what material will sign be constructed? Frame......... : 5 �.............
Face.........w............ .....-...........
13. Estimate cost..7.�z
The undersigned certifies that the above statements are true,to the
best of his knowledge and belief.
..............»..»....».�».,..,..»,.,....». .... ..1......................
._..
(Signature of Owner or Agent)
NOTE: In order that this application may be accepted, the data called for above must be set forth
CLEARLY and FULLY.