23A-005 (6) DEPT. FILE COPY 1.
DEPARTMENT OP BUILDING INSPECTIONS Z0
NORTNM�TMAIN O, MA, 01060 CODE #79 PERMREET IT ;a
PERMIT VALIDATION
DATE Pahrnary 24_ is SD_ PERMIT HO. 113
APPLICANT Manpn S.revana, .rr ADDRESS 16 MeatInw St Plorinte
IRO.) ISTREETI. - (CONTR'S LICENSE)
NUMBER OF
PERMIT TO wa allOFPlnn — WlML aeon ) STORY POT wnndhrntIIl'n4a DWELLING U
HITS_ 1
{TTP£ IMPROTEMET
R . (PROPOSER USE?
ON
AT (LOCATION) 36 Meadow DISTRICT.21E8_..,—
ilia/ (STREET)
en BETWEEN Ma6dow AVIS AND_.., Lilly Street
vo (CROSS STREET) (CROSS STREET)
0.
LOT
a• SUBDIVISION LOT BLOCK SUE
K
p BUILDING IS TO SE FT. WIDE BY —FT. LONG BY -..—FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
a
a
Z TO TYPE USE OROUP BASEMENT WALLS OR FOUNDATION
DE ORM
a
IOL REMARKS: )nevelt wood-b"rotug etOvv III evicting ChiNnny
AREA OR
VOLUME ESTIMATED COST $ 179 00 FEEMIT $ 10 00
)CUB¢/SRVARE FEET) �'�, ,P
OWNER Nieman 9trreni lr 1 / {��/
ADDRESS 26 Meador& Ct P Wjnranra eUJ, / f
(Affidavit on reverse side of application to be completed by authorized agent of owner) /
r"
I hereby certify that the proposed work is authorized by the owner bf retard
and I have been authorized by the owner to make this application as his
authorized agent.
SIGNATURE OF AErENT
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 2PLAN EXAMINATION AND
d'.3 4 — BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: I, II, III, IV, and IX. aft-
AT
J f� O
p,, -eruct }Lt-t C_�j�{ ZONING {,(/�((-
I AT (LOCATION) )9CSC w�iia/ 'LtLC � DISTRICT
LOCATION (No.) r.r [� y Q(STREET) �./ (((```
OF BETWEEN I ,^" JS kf/ AND
BUILDING (CROs STREET)
E ) 424.
1 ICROse 1
LOT
SUBDIVISION LOT BLOCK SIZE
ce
II. TYPE AND COST OF BUILDING — All applicants complete Ports A — D —I
A
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use III
In
1 I New building Re dentia I Nonresidential —,
2 I I Addition('f residential, enter number 12 One family 1B L1 Amusement, recreational
of new housing units added, if any, 131 I Two or more family — Enter 191 I Church, other
inPart o 13)n religious
number of units— — — — y 20 Li Industrial
3 I Alteration (See 2 above) 14 I I Transient hotel, morel,
4I 1 Repair, replacement or dormitory — Enter number 21 Ln Parking garage
5I 1 Wrecking (II multifamily residential, of units y 22 LI Service station, repair garage
enter number of units in building in IS I 1 Garage 231 1 Hospital, institutional
Part 0, 13) 16 1 I Carport 24 n Office, bank, professional
6 I 1 Moving (relocation) 17 n Other — Specify 251 1 Public utility
71 I Foundation only
ry/,��J /,, 26I 1 School, library, other educational
B. OWNERSHIP /t^"'f""'"��' r I 271 I Stores, mercantile
Elyrt (individual, corporation, _ d,� 26 Tanks, towers
f J,nonprofit institution, etc.) c" '-7 29I 1 Other — Specify
9 1 I 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 $ 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
1.b. Plumbin9C r . i. / tai
c. Heating, air conditioning J�'Jo a
d. Other
tor, etc.)
11, TOTAL COST aOF IMPROVEMENT $ .J / /.
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
for wrecking, complete only Part.1, for all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPEOFOF SEWAGE DISPOSAL J. DIMENSIONS
30 L J Masonry (wall bearing) 40,Ly Public or private company4B. Number of stories
�y 49. Total square feet of floor area,
31 y�1 Wood frame 41 I I Private (septic tank, etc.) all floors, based an exterior
32 I Structural steel dimensions
33I I Reinforced concrete H. TYPEI��II OF WATER SUPPLY
341 I Other — Specify 424k1 Public or private company 50. Total land area, sq. ft
43 I Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL St. Enclosed
35 I 1 Gas Will there be central air 52. Outdoors
36® Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
3 37 in Electricity 44 I 1 Yes 45 12rNo53. Number of bedrooms
36 1 Coal /
39 I I Other — Specify Will there be on elevator? 1 Full
54. Number of 1
46 1 1 Yes 47 Z No bathrooms
Partial
r
NOTES and Data — (For 6/1-4-121
deppartment use) pp a C
IV, IDENTIFICATION — To be completed by oil applicants
Name Moiling address — Nerrerbrr, xrnrcer, any, and State ZIP code Tel. No.
n:nerM n J `Sie, ev> 36 nie4de „ SSIL -/ „1
or 'T'�o re yc-E; 53aT
Lessee O /06n
eihe.s
2. Af' +'t ❑cense No.
Contractor
Al hi lett 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
Plans Review Required Check Plan Fee w Date Startednz By Ate opvrovedS 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 Obtoi ed 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 ry FOR DEPARTMENT USE ONLY
Permit number )
Building fr7use Croon
*?',• —....
Permit issued tc�— at 19 yo
Building Fire Grading
Permit Fee $ 10 i}3 Live Looding
Certificate of Occupancy $ Occupancy Load _
Ap•roved by:
Drain Tile Sa ! F
Plan Review Fee $
TITLE
VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
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SetA FORM AEEBY - 659 CI969 OUILDIN6 OEFICIALS IS CORE ADMINISTRATORS INTERNATIONAL, INC,