16A-017 (5) DEPT. FILE COPY
DEPARTMENT OF BUILDING INSPECTIONS Z°
"n 212 MAIN STREET BUILDING as
NORTHAMPTONt MA. 01060 PERMIT
l- VALIDATION
16A - 17
DATE Ma 8 19 79 PERMIT NO. 188
APPLICANT R41-I in McDonald ADD ESS 379 Spring
(NO.) (STREET) . - (CONTR'S LICENSE)
NUMBER OF
PERMIT TO C.r-mg+.ymn t. RYtpcl ( 1 STORY_ .S'�qg - S'�1 -d DWELLING UNITS 1
(TYPE OF IMPROVEMENT) NO. r (PROPOSED USE)
AT (LOCATION) 379 Spring ZONING 'URA
DISTRICT
(NO.) (STREET)
i
rn .BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
m SUBDIVISION LOT' BLOCK SIZE
a
U
O BUILDING IS TO BE 8 FT. WIDE BY 12 FT. LONA BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O
Z TO TYPE USE GROUP OASEMENT WALLS OR FOUNDATION
(TYPE)
It
u- REMARKS: Construct storage shed cuan(j
e
AREA
I
f
I
i
VOLUME E4TIMATED COST $ 230.00 FEEMIT Q� 10.00
(CUBIC/SQUARE FEET) ,P
i
i
OWNER Rollin MoDnnald
BU DI �DEPT
ADDRESS I
(Affidavit on reverse side of application to be completed by authorized agent of owner)
hereby certify that the proposed work is authorized ,by the Owner oferecord
and I 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
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 PLAN EXAMINATION A N D
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, III, IV, and IX. O
I• AT (LOCATION) -� 4L ZONING
DISTRICT
LOCATION (NO.) REET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D -i
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
M
1,,0 New building Residential Nonresidential
2 ❑ Addition(If residential, enter number 12One family 18 ❑ Amusement, recreational
of new housing units added, if any, J_
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,
4 Repair, replacement or dormitory - Enter number
�iL-J1 21 Parking garage
Wrecking (IJ 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 �4❑ Office, bank, professional
6 ❑ Moving (relocation)
17 Other — Specify i r '( f25 ❑ 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 — 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,,,,,,,,,,,,,,,, �/f%I 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) 40 ❑ Public or private company
4948. Number of stories...... Total square feet of floor/..........
31 _ Wood frame 41 ❑ Private (septic tank, etc.) all floors, based o or
x eriarea,
32 Structural steel dimensions ..... ,.... L�/
❑ -
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other — SpeciJy 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 [__1 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 ❑ Coal
39 ❑ Other — Specify Will there be an elevator? Full..........
54. Number of
46 ❑ Yes 47❑, No bathrooms Partial........
NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, strut, city,'and State ZIP code Tel. No.
Owner or
Lessee
G' 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
makeahis application as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
1;1g to of app '.,cant Address Applicat�iond,-Jate
'
D0 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
q Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
te Date
Permit or Approval Check Obtaatned 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
V11. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issuedGC7�!r L 19
�
Building Fire Grading
Permit Fee $ A,%_.�� i Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
VIII. ZONING PLAN EXAMINERS NOTES f '"
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
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