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17C-227 (24) VIII. ZONING PLAN EXAMINERS NOTES DISTRICT USE FRONT YARD SIDE YARD SIDE YARD REAR YARD NOTES IX. 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IV. IDENTIFICATION — To be completed by all applicants Name Mailing address — Number, street, city, and State ZIP code Tel. No. 1. W Owner or Lessee U I��0 Builder's 2. License No. Contractor Y✓" �� J 6�a 1U47 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 applicant Address Application date 00 NOT WRITE B E L 0 THIS LINE V. PLAN REVIEW RECORD — For office use Plan Review Date Plans Date Plans Plans Review Required Check Fee Started By Approved By Notes BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL $ OTHER $ VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Date Date Permit or Approval Check Obtained Number By Permit or Approval Check Obtained Number 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 Building Use Group Permit issued 19 _ Building / Fire Grading Permit Fee $ < Live Loading Certificate of Occupancy $ Occupancy Load pr d by: Drain Tile $ Plan Review Fee $ TITLE NOTES and Data — (For department use) CITY OF NORTHAMPTON OFFICE OF THE INSPECTOR OF BUILDINGS 212 MAIN STREET APPLICATION FOR NORTHAMPTON, MA. 01060 / 17� l�° fJ� PLAN EXAMINATION AND BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O / �t 1• AT (LOCATION) � � 1 {' r ide r+�i .LP /Ld./eLifi✓ D ZONING ISTRICT �.� LOCATION (NO.) (STREET) OF BETWEEN Mai yx AND A$—4 Lt1 E,.// 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 1 ❑ New building Residential Nonresidential 2 �Addition(If residential, enter number 12 F-1 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— — — — i 20 ❑ Industrial 3 ❑ Alteration (See 2 above) 14 l t l t t h i Transenoe , motel,❑ 21 ❑ Parking garage 4 ❑ Repair, replacement or dormitory — Enter number 5 F] 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 ❑ Carport 24 ❑ Office, bank, professional 6 [_-] Moving Moving (relocation) 7 F—] Foundation only 17 Other — Specify 25 ❑ Public utility 26 ❑ School, library, other educational B. OWNERSHIP 27 ❑ Stores, mercantile 28 ❑ Tanks, towers �!� n- 8 ©Private (individual, corporation, 29 Other — S eci (it/t.� nonprofit institution, etc.) ❑ p fY 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................ dCt 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..................... b. Plumbing ..................... c. Heating, air conditioning.......... d. Other(elevator, etc.)............ 11. TOTAL COST OF IMPROVEMENT $ A 111. 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. .Q(1.f.8.... 31 Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area all floors, based 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 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37❑ Electricity 44 ❑ Yes 45 �No 53. Number of bedrooms.............. 38 ❑ Coo I 39❑ Other — Specify Will there be an elevator? Full.......... 54. Number of 46 ❑ Yes 47 [eNo bathrooms Partial........ hereby certify that the proposed work is authorized by the owner cif rECOrd.. and 1 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 ZO DEPARTMENT OF BUILDING INSPECTIONS BUILDING 0a 212 MAIN STREET NORTHAMPTON9 MA. 01060 PERMIT VALIDATION 17C - 277 CODE #79 DATE_ may 171 19. 80 PERMIT NO. 2A APPLICANT Wren F, Qmvk ADDRESS a( (fTR@_ t. NO.) NO_ "a��(STREET)S � F I n- (CONTR'S LICENSE) NUMBER OF PERMIT TO (�_) STORY Dia_ar., gV ArEaZ DWELLING UNITS TYPE OF IMPROVEMENT) N0. (P OPOSED USE) ZONING CB AT (LOCATION) 16 North Male DISTRICT (NO.) (STREET) m BETWEEN Main AND Bardwell fo (CROSS STREET) (CROSS STREET) a LOT e SUBDIVISION LOT BLOCK SIZE m a ADDITION p XjaOMIS TO BE 10 FT. WIDE BY 1g FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION m Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) 0 u. REMARKS: Rug area fer- mork AREA OR 180 ESTIMATED COST __3 0 00 FEE MIT Q 10.00 VOLUME . �P (CUBIC/SQUARE FEET) e OWNER Jejeeph R. WnC4 BUI ADDRESS BY X4 4 Z99. (Affidavit on reverse side of application to be completed by authorized agent of owner)