10D-017 BUILD PERMITS (3) � a
DEPT. OF BUILDING INSPECTIONS BUILDING z°
! 212 Main Street �a/
Northampton, MA 01060 PERMIT / ((�
VALIDATION
DATE :Z # 19 YR IT NO. —
APPLICANT ` ` - lA(`I ADDRESSi rS8 APaI�TN �1RjE L� V� G
(� / � -�(NNO.)7�fh, cOF
,+ (STREET) c !K� (CONTR'S LIC//ENS
PERMIT TO "'" IN�T (--L) STORY `.�0" r��`' /V'V vy�®Tt� �+�� -DWELLI /71
NUMBENG
UNITS "-
(TYPE OF IMPROVEMENT) NO. —? (PROPOSED U EP / s
{
AT (LOCATION) ZONING
DISTRICT S!
(N .) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT_._BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BYI ✓ FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
I
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION '
(TYPE)
REMARKS: Al
I,
ARE
ER
VOLUME ESTIMATED COSTR 44L. 4'' FEE rF '
(CUBIC/SOUA FEET)
A,V r
JA
OWNER L� r�J �c,
ADDRESS
C) p BYILDIN D
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - S SSORS COPY pjNT P
r CITY OF NORTHAMPTON
�• .�
MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page Plot APPLICATION FOR
INSPECTOR j ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
I• ZONING
AT (LOCATION) 1 ``..a �'� �_ C DISTRICT
LOCATION (N0.) (STREET i I
�a/�
OF BETWEEN 44:1 AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
f/t!
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
I �
1 XNew 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 nits– – – – -- 20 Industrial
3 Alteration (See 2 above) 14 ❑ Transient htel, motel,
21 Parking garage
4 ❑� Repair, replacement or dormitory – Enter number
f
5 Wrecking (11 multifamily residential, o units — ————— — -� 22 �❑ Service station, repair garage
❑�
enter number of units in building in 15 ❑, Garage 23 Hospital, institutional
Part D, 13) 16 ❑J Carp ort 24 ❑� Office, bank, professional
6 ❑ Moving (relocation) ��.
7 ❑ Foundation only 17 Other — Spe( 25 Public utility
26 School, library, other educational
B. OWNERSHIP 27 L❑ Stores, mercantile
8 Private (individual, corporation,
28 n Tanks, towers
nonprofit institution, etc.) 29 F Other — Specify
9 ❑ Public (Federal, State, or
local government)
C. COST (Omit cents) Nonre idential — Describe in detail proposed use of buildings, e.g., food
p ing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,,,,,,,,,,,,,, Q p �secondary school, college, parochial school, parking garage for,
rotes
school
de artgnent 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....................... T'` e"
Y V
b. Plumbing ....................... I
TE r S a N J
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $ O (�
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
for wrec ing, complete only Part J, for all others skip to IV.
E.
30 Masonry (wall bearing) 40 Public or private DISPOSAL J. DIMENSIONS M ��
48. Number of stories................
PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DI
❑ � ICom pony
31 ❑ Wood frame 41 ❑ Private (septic tahk, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 Structural steel dimensions
.....................
34 Other PLY
33 ❑ Reinforcedconcrete
1e H.2Yr�'�,ublPE OF Vc oTprR ate company 50. Total land area, sq. ft. ...........
43 [ Private (well, cis�ern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRININ❑AL TYPE OF HEADING FUEL I. TYPE OF MECHANICAL
35 Gas A4�X
be central air 1 52. Outdoors........................
❑�36 Oil9L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 45 irINo 53. Number of bedrooms..............
38 n Coal
39 Other — .Specify Will there be on elevator Full.........
—/" 54. Number of
r
46 I _� Yes 47 �No bathrooms
Partial........
I
I
IV. IDENTIFICATION — To be completed by all applicants
Name (' Mailing address — Numbrr, street, city, and State ZIP code Tel. No.
Owner or
Lessee i r
U N� Builder's
2. License No. V4
Contractor
E� 'a&r
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.
lure of applicant Address Application date 1
Ls ) a�_� L M C:�A , T%<.Q (�—
NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
ote Plate Plan
Plans Review Required Check PlonFeeview DStartedns By DApproveds BY Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
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 lam ` �/ 1900
Building Fire Grading
Permit Fee $ Z Wo`W Live Loading
Certificate of Occupancy $ Occu ncy Load
Approved by-
Drain Tile
Plan Review Fee $ C
TITLE
NOTES and Data (For department use)
ZONING
DISTRICT
USE
FRONT YARD
SIDE YARD SIXE YARI
IX. SITE OR PLOT
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