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SIDE .D
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NOTES and Data — (For department use)
R!L
pe-41 Div 2 a v' Gq L e4 4
F
IV. IDENTIFICATION — To be completed by all applicants +,
Name Mailing address — Number, street, city, anti State ZIP code Tel. No.lifo. 1 o ,o ,�. otb b o
Owner or
Lessee
Builder's
2. 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 a licatio his tho ized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature f p lica Address Application date
ty
r
r 00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
9 Fee Started y Approved y
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 11
Building- Use Group
Permit issued 19
Building Fire Grading
Permit Fee $ Live Loading
Certificate of Occupancy $ Occupancy Load
A rov d by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page ":K 2 Plot 5:67
— APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. C)
ZONING
I•
DISTRIC
AT (LOCATION)
LOCATION IN 0.) (STREET)
OF BETWEEN AND
BUILDING CROSS STREET) CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
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
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— — — — —>
3 Alteration (See 2 above) 2 ❑ Industrial
¢/IrI 14 ❑ Transient hotel, motel, 21 1 L❑ Parking garage
Repair, replacement or dormitory — Enter number
_—————— — 22 ❑ Service station, repair garage
5 ❑ Wrecking (IJ multi/amily residential, of unzts --�
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 27 ❑ Stores, mercantile
\��* 28 ❑ Tanks, towers
B D�I Private (individual, corporation, 29 Other — Specify
•/`i�' nonprofit institution, etc.)
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................ 800 school, secondary school, college, parochial school, parking garage for.
department store, rental office building, office building at industrial plant.
7'o 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 $ b 8 D
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) 40Public or private company 48• Number of stories...............
49. Total square Feet
3Wood frame 41 ❑ Private (septic tank, etc.) floor area,
all floors, based on n exterior
32 Structural steel dimensions .....................
33 ❑ Reinforced concrete H. T PE OF WATER SUPPLY
34 ❑ Other — Specify 4 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........................
conditioning?
36 [� Oil L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 ❑ Yes 45 No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevator? Full..........
54. Number of
46 P Yes 47XNo bathrooms
Partial........
. TMENT OF BUILDING INSPECTIONS
2 T2 RAIN STREET BUILDING o°
'NORTHAMPTON, 01060 PERMIT a a
18D - 35 " 36 VALIDATION
DATE Sprk nmhPr 28, 19 81 PERMIT NO. 548
APPLICANT AUgifetile Acrfi to ADDRESS 48 Damon Road
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO (2-1 STORY RPStuarant DWELLING UNITS
TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) 48 Damon Rnad "pall as" -- DISTRICT GI
(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. Refurbish, rPmnvP Old wal i C� rnlnratn ha
AREA OR PER MIT 1O_OO
VOLUME ESTIMATED COST $ ��QQ FEE
(CUBIC/SQUARE FEET)
OWNER Anouctzle Farfi t.O Bu DI T
ADDRESS 48 Damon RA NOrthAut^r, Ma- n' "a B
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY ■ PINK - AS ESSORS COPY