10D-017 BUILD PERMITS (4) CITY OF NORTHAMPTON
g• g /�"""` MASSACHUSETTS
U I
CE of the IN�PECTOR of BUILDINGS
AM 15 %7 Page Plot APPLICATION FOR
ZONING PERMIT AND
I N S P E OFBtntDINGI BUILDING PERMIT
NORIHAMPTOAt, �WECTIONS
IMPORTAN — pplicant to complete all items in sections: 1, Il, 111, IV, and IX. O
I•
AT (LOCATION) rr1 st I ,�eeaLs DSTRCT�r••�X
LOCATION (N0.) (STREE )
OF BETWEEN � �� AND lb-eYY lr
BUILDING (CROSS STREET) (CROS STREET)
/,0,0/0/9�a Q/
LOT 9. 3Y4c--s 3
SUBDIVISION LOT BLOCK SIZE �C
N
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
M
1 X New building Residential Nonresidential
2 El 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 E Two or morel family - Enter 19 Church, other religious
number of nits- - - - -� 20 Industrial
3 Alteration (See 2 above) 14 Transient h tel, motel,
21 Parking garage
4 E] Repair, replacement or dormitory - Enter number
J
5 L:1 Wrecking (1/multifamily residential, o units -1------ - -- 22 L7 Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 n Hospital, institutional
Part D, 13)
6 Moving (relocation) 16 Carport i 24 Office, bank, professional
17 Other - SO cify 25 Public utility
7 Foundation only 26 School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8;, Private (individual, corporation, ! 28 Tanks, towers
nonprofit institution, etc.) 29 Other - Speci1y6)K'C1e<<A
9 [::] Public (Federal, State, or
local government) Con T' a 12, y �ik jfI'
C. COST (Omit cents)
10. Cost of improvement••,•„••,•,••,•, Q �I
To be installed but not included �-T
in the above cost
a. Electrical....................... 0715-46 f) �' y
b. Plumbing .....................
c. Heating, air conditioning.......... Q � A;-
,I
�
lI S h ',,, e
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $ () QOU 'y -
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. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL
30 Masonry (wall bearing) 40 Public or private(company I
i--- -- _
31 Wood frame 41 Private (septic tank, etc.)
32 Structural steel
33 Reinforced concrete H. TYPE OF WATER SU PLY J
_...TJQ._TOT(j i'..Tanaareu, may. _
34 � Other - Specify 42,K Public or private Company
43 ❑ Private (well, cisltern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICt L 51. Enclosed .......................
35 F_� Gas Will there be central air Ili 52. Outdoors........................
36 Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 n 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........
IV. IDENTIFICATION — To be completed by all applicants 'F•'`
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or ,e�u YIe t 7a�-Y 3� �a R 5T, 'Ne e-e4c4
o
Lessee
Builder's
2
License No.
Contractor OT—
"46 j 1
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 authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signat re applicant ' Address Application date
LZOO 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
Date Permit or Approval Check Obtained Number By Permit or Approval Check Obttaitned 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
V11. 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
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
NOTES and Data (For department use)
ZONING •
DISTRICT
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
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DEP 6'lr'l!UILDING INSPECTIONS � BUILDING Z°
212 Main Street o<
Northampton, MA 01060 PERMIT
VALIDATION
-- --
''`�'j� /DATE � �"' f 19 APERMIT NO. ,�,/
APPLICANT !r ._) t
f"X: ! A( �i ADDRESS1 Y` j i ;&/W ,� �I A '/ 1s", ,
(NO.)
f 99 (STREET) p (CONTR'S LICENSE
PERMIT TO �. 6�✓ �v.?1 ( 1 STORY < yt f rt e'f(i 1 � ;F� `�4 NUMBER OF
DWELLING UNITS I
(TYPE OF IMPROVEMENT) NO. (PROPOSED U °'
ZONING <
AT (LOCATION) JVWJ 1 DISTRICT—
IN .) (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: r .—_, t,� ;a �� t i {�� .� �.AREA
,�.
VOLUMER ` 6z+ ESTIMATED COST $ f , L/ FEEMIT $
(CUBIC/SOUAR FEET)
OWNER 7 �°+0 —
t BUILDING DEPT.
ADDRESS
Y A (1 BY
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY • PINK - ASSESSORS COPYPINT P
175 l4a�n Street, Leeds
DEPARTMENT ' F PUBLIC WORKS
125 L cust Street
Northam on,Mass.01060 D.S.# $$392124
Telephone 86-6950 ext. 270
No. 7469
TRENCH A�OVOISAPPROVED
�l i
Date„ �..-?
PERMITy (Department of Public Works)
No work to start until signed.
� I
This permit(license for digging up any street or sidewalk)is issued under the provisions of Chapters 32 and I$t,A of the Revised
Ordinances of the City of Northampton nsuWttct to tzSp ifications for Care of Street Cuts"approved and adopted by the
Department of Public Works on 1 .The applicant.hereby agrees to protect all cuts with bar-
ricades and lights,and to save the City of Northampton har less from all claims for damages whatsoever arising from the oc-
cupation of the highway,until such time as the work has ben approved and accepted by the Department of Public Works as
provided for below,and in the case of private utility, to pa all charges for resurfacing.
1. Name of Applicant Tacy Excavat ng 9/28/8$
Address _.. 158 North e Street, Florence
By
;j ..GA hd.,lij presentative)
2. Location and description of proposed trench and utility (if any), and purpose of cut:
Thi; permit will allow thejapplicant to put in stubs to the property.
Seeds ll 8t.. actual tie in to the building are subject to receipt of all proper permits.
Leeds The &tubs should be done itsmediately prior to the City's new sidewalk consi
3. Estimated dates of occupation of street tio,
IIIII�I���I �r•III�III� '
4. (To be filled in by Engineering Department)
Location (line and grade) assigned:
,I
UTILITIES NOTIFIED:
Verbal — ldain to .street Line
DATE
SIGNED a
Signe %'4a 7
g , Ctty Engineer.
5. Constructed to line and grade as assigned. Ara sq. yds.
j
Date Signed , City Engineer.
6. Completed work approved and accepted.
Date
By
(Department of Public Works) 11r iNf' r
-�w�wl