07-004 (6) aate_ qfi
DEPT. OF BbILDING INSPECTIONS BUILDING
D
#_.j it, 212 Main Street 0a ¢l ft, (Tho
-_ - Northampton, MA 01060 PERMIT 511 /L
7 - 4 VALIDATION
PATE August 3 is R7 PERMIT NO. 503
APPLICANT NPiI Kp1ley ADDRESS 116 Nnrth Farms Rnad owner
I NO.1 NITRES,/ tcONn.R LICENAu
PERMIT TO in-frnnNl Pnnl t a I STORY NUMBER OF
One Family Owpll inQ NBEOF
TYPE or I MIWEN
NOVEn VROPOSEO Naar
AT (LOCATION) S16 Nnrth Farms Rnad ZONING
(MOA (KTNEEY/ DISTRICT RR
BETWEEN AND
([ROES STREET/ /mase STREAM
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT ANO SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
ITT/NO
REMARKS. permit fnr the inctallatiorl of an in..Qr /Ind Swipirig pnpl
AREA OR
VOLUME ESTIMATED COST $ 0,0015,00
"EM(T $
10 00( FACT/
BWNER Mme as Applicant I�9
ADDRESS Same as Appllcnatls SY
WHITE - FILE COPY • CREEK • FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY P47`4,.
1f^:1CITY OF NORTHAMPTON
MASSACHUSETTS
A�'',)
t. l OFFICE of the INSPECTOR of U LDINGS
_"�' Pa e 7 Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, II, 111, IV, and IX. o
DIST
AT (LOCATION) .57‘ NQS i F2r}J Rd DISTRICT
rk
LOCATION INo.1 ISTREETI
OF BETWEEN ICFass STREET) AND (CROSSMEET)
BUILDING s
LOT
SUBDIVISION Lot BLOCK SIZE
an
II. TYPE AND COST OF BUILDING — All applicants complete Ports A — D —I
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
IT
-4
I New building Residential Nonresidential
2❑ A• ddition(1/ residential, enter member 127 One family IS I I Amusement, recreational
o/new housing units added, if any.
in Part D, 13) 13 I I Two or mare family - Enter 19 r, C• hurch, other religious
3 A• lteration (See 2 above) number of units- ----1 20 LL Industrial
l
14 n Transient hotel, motel, 21 El Parking garage
4 I Repair, replacement or dormitory - Enter number
51 I Wrecking (II multifmnily retrdentlal. of units - y 22 [1 S• ervice station, repair garage
enter number of untts in building in 15 0 Gorage 23 7, Hospital, institutional
Part 0, 131 16 L7 Car24I 1 Office, bank, professional
��
6 L I Moving (relocation) port
17�� Other - Specify I e/CIOA 25 ❑ Public utility
7 1 I Foundation only
261. 1 School, library, other educational
B. OWNERSHIP -- In- n• it ROA,
(]OOA, 2 [_ ] Scores, mercantile
28 j 1 Tanks, open
B LI Private (individual, Corporation,
nonprofitm etcc
n, etc.) 29 El Other Specify
9 I I Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential - Describe in detail proposed use of buildings, e.g., food
processing plant, machineshop, laundry building at hospital, elementary
10. Cost of improvement $ schoolS1 secondary school, college, parochial school, parking garage for
department sat
rental office building, office building 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. Plumb' g
c. Heating, air conditioning
d. Other(elevator, etc.)
II. TOTAL COST OF IMPROVEMENT $ e 00//
III. SELECTED CHARACTERISTICS OF B ILDING — For new buildings and additions, complete Ports E — L;
for wrecking, complete only Port J, for all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
FPI I Masonry (wall bearing) 401L I Public oprivate company 48. Number of stories
31 El Wood frame 41 7 Private (se tanka c.) 49. Total square feet of floor
p(c t all floors, based on exterior
32 I I Structural steel dimensions
331L Reinforced concrete H. TYPE OF WATER SUPPLY
34 7 Other - Specify 42 E1 Public or private company 50. Total land area. sq. ft
43 0 Private (well, cistern) K. NUMBER OF OFFSTREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL sit. Enclosed
35I i Gas Will there be central air 52. Outdoors
36 I I Oil condinonl ngo L. RESIDENTIAL BUILDINGS ONLY
-
37 I i Electricity 44 i I Yes 45 No 53. Number of bedrooms
39 I Cool
39 0 Other - Specify Will there be an elevator' 1 Full
54- Number of
08 [-1 Yes 47 .`i No bathrooms
Partial
Th.
IV. IDENTIFICATION - To be completed by all applicants
Name Mai ling address — Number. serer, rzry. and Satre ZIP code Tel. No.
O1. ar
L /Je;! 1<2lle4 S/� Auo.IX ✓s c/o c 54f
3/y6
Bui'del's
]. License No.
Contractor
J.
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.
Signature of applicant Address Applic tic date
lag-.--'1017 zi� S/ A) CT r I�?S 4/ ''�g7
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD - For office use
Plans Review Required Check Plan Review Date Plans Dote Plans ByNotes
quire Fee Started By Approved
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 5-0? FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued ' 41 ,3r 19Q-7�
Building COFire Grading
Permit Fee $ 1 .1 ' CLive Loading
Certificate of Occupancy $ Occupancy Load
Approved by: C ��
Drain Tile $ �9 (�
Plan Review Fee $
TITLE
NOTES and Data — (For department use)
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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