17C-226 (9) r t
VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
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SIDE YARD SIDE YARD
REAR YARD
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BOCA FORM APEBP — 669 C1969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
1.
Owner or � �
Lessee
Bui Ider's
2. i ! ;`�{ ! L. �? !n t R e s t r.. r 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 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 BELOW 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 ,�. �j Use Group
Permit issued 19e7
Building Fire Grading
Permit Fee $ Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile
Plan Review Fee
TITLE
NOTES and Data — (For department use)
f l
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 PLAN EXAMINATION AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O
,c.... ar ZONING /.
I• AT (LOCATION) �� f � ° " � � DISTRICT( 7"�
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
V1
II. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use M
1 ❑ New building Residential Nonresidential
2 ❑ 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 Transient hotel, motel,
❑ 21 ❑ Parking garage
4 Repair, replacement or dormitory Enter number
/ � 22 ❑ Service station, repair garage
,<
reeking (If multifamily residential, —=
of units — — --
enter number of units in building in 15❑ Garage 23 ❑ Hospital, institutional
Part D, 13) 16 ❑ Carport 24 E] 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
8y 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••,,,,••..•..... I t zi4l 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 Is
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) p p y 48• Number of stories.............
40 Public or rivate com an
31 Wood frame 41 ❑ Private (septic tank, etc.) 49• Total square feet n floor area,
all floors, based on qXUrior
32❑ Structural steel dimensions ..... �.�
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
42 Public or private company 50. Total land area, sq. ft. ...........
34❑ Other — Specify � p p y
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 ❑ Coo I
39❑ Other — Specify Will there be an elevator? Full..........
54. Number of
46 E] Yes 47'A No bathrooms Partial........
hereby certify that the proposed work is authorized by the owner of regord
and I have been authorized by the owner to make this application as his
authorized agent.
SIGNATURE OP AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
DEPT. PILE COPY
DE2�T�TO�BUILDING INSPECTIONS BUILDING III,
NORTHAMPTON, MA., o 1 o6o PERMIT
VALIDATION
17C — 226 Code #79
DATE October 17, 197_ PERMIT NO. 606
APPLICANT Ra nn D Newell l ADDRESS R.F.D. Kennedy Rd. , Leeds
(NO.) (STREET). (CONTR'S LICENSE)
NUMBER OF
PERMIT TO RPrT)S]�_r (�) STORY Repair store DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING GB
AT (LOCATION) 1P Nn._Manl e Street, Florence "Lamontaime I s" DISTRICT
(NO.) (STREET)
rn BETWEEN AND
ro (CROSS STREET) (CROSS STREET)
O�
LOT
IL SUBDIVISION LOT BLOCK SIZE
m
a
U
O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
M
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
I (TYPE)
IX
U. REMARKS: R=I ace -Front r)orch and f Bing
/r/al7f �t
AREA VOLUME ESTIMATED COST .$ 1 000 FEEMIT 10.00
(CUBIC/SQUARE FEET)
OWNER R avmond T) Newell J
BUI INGf E
ADDRESS R.F.D. Kennedy Rd Leeds BY
(Affidavit on reverse side of application to be completed by out orized agent of owner)