06-045 DEPT. RLE COPY
zD
s CITY OLS BUILDING P
•,, Nmenmeroor
r 1(135, PERMIT VALIDATION
6-45
DATE fannmber 9, 19 77 C�^. PERMIT NO. 3R
APPLICANT Qnnrg. Mtn 1yMNnd ADDRESS Ixa.Q Pot 593 1Atitumv}4Anr SOx- Ta tic[xaEl
NUMBER OF
PERMIT TO Q4 /fn dw»ne 1 1 STORY RAMid/MC DWELLING UNITSt
(TYPE OF IMRROVCMVNTI NO. RD LIE)
ZONING
AT(LOCATION) 217 Awynamrt 11e Road DISTRICT_.aR
IR0.1 (STRUM
BETWEEN __ ANO —
(CROaf sTREETI (CROSS STREET)
LOT
00'• SUBDIVISION LOT BLOCK SITE --
O• BUILDING IS TO DE FT. WIDE BY FT. LONG BY FT. IN HEIGHT ANO SHALL CONFORM IN CONSTRUCTION
C
2 TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
I (TYPE)
G
N• REMARKS: Instal two wlsdon — not replacement
VOLUME ESTIMATED COST $ J51 FEEMIT • to CO
I[1R C(SOUPRE FEET)
OWNER RMEfTgA Tint 1yfeMYlt
.F.... eUl
ADDRESS (t Wit 513, tIf1Stl rd tan, M.*sn. BY
(Affidavit on reverse side of application to be completed by authorized of owner)
I hereby certify that the proposed work is authorized by the owper.-of„record'- s-
and I have been authorized by the owner to make:this application as his
authorized agent.
SIGN URE OPAGENT
ADDRESS ._ .. ...
.,. (NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19_.
t n�ik
(tt�'j}; „( (City of Northautpton
`.j I' jl �asaachnsetts
»0._ n.:17y> Office of tilt 31nspector of Illitilbinps
APPLICATION FOR
Page 4, Plot AiZONING PERMIT AND
BUILDING PERMIT
IMPORTANT - Applicant to complete all items in sections: I, II, III, IV, and IL Z
O
/
5 y/J -
z i ./ Ps/VY/{.LL /Lv ZONING t
I• AT (LOCATION) DISTNICIC
LOCATION (No.) IsTREETI
OF BETWEEN AND
BUILDING (CROSS STREET, (CROSS STREET/
LOT
SUBDIVISION LOT BLOCK SIZE
4
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — 0 y
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
m
a
1 I New building Residential Nonresidential
2 I Addition(If residential, enter number 12[ One family 18 L I Amusement, recreational
if new n Part D. 13) units added, if any,
r 13I I Two or more family — Enter 19I I Church, other religious
E�
number of units— — — — y 20 r Industrial
31n 1 Alteration (See 2 above) ty 1 I Transient hotel, motel,
01 I Repair, replacement or dormitory — Enter number 21 Parking garage
5 Li Wrecking (If multifamily residential, of units — . 22 n Service sr a r i on, repair garage
enter number of units in building in 15 J Garage 23l 1 Hospital, institutional
Part D, 13)
6 Moving (relocation) 16 I Carport 241 I Office, bank, professional
T Foundation only W I I Other — Specify 251 I Public utility
26 Li School, library, other educational
B. OWNERSHIP 27 1 1 Stores, mercantile
R k Private (individual, corporation,
PT Tanks, towers
ooration,
nonprofit institution, etc.) 291 I Other — Specify
9 r1 Public (Federal, State,or
local government)
C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food
processing pplant, machine shop, laundry building at hospital,elementary
10. Cost of improvement $ 2'S� school, secondary school, college, parochial school, parking garagefor,
department store, rental office building, office building at industrial plont.
To be in ,ailed 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 (elevat J
I1. TOTAL COST OF IMPROVEMENT $ 2 rv'
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L; a
for wrecking, complete only Part J, for all others skip to IV. D
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
m
30[ J Masonrybearing) private company Number of stories
(wall 90 Public or 49. Total feet of floor Of a,
31 IX' Wood frame 41 r.�l Private (septic tank, etc.) square
all floors, based on exterior
32 I I Structural steel dimensions
33 I Reinforced concrete H. TYPE OF WATER SUPPLY
341 1 Other — Specify 4214 I Public or private company 50. Total land area, sq. ft
43 FT Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosedr
0
351 I Gas Will there be central air 52. Outdoors Al
36 IK Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 Li Electricity 44 7 Yes 45 Li No 53. Number of bedrooms
38 Coal
39 1 I Other— Specify Will there be an elevator? { Full
54. Number of
461 I Yes 47 I I No bathrooms
Part-al
IV. IDENTIFICATION — To be completed by oil applicants
NameZIP code •TeI No.
o.:ne, an v dad./lAttr000d) fa ?OA ,/2.I Nemi inimmd .1-mt _ 4 d40 Ler ST¢91r'u'
Lessee
a Seri— }Y ~mein. eeaae No.
Contractor - -
AtcGteot
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 us his authorized agent and we agree to conform to all applicoble lows of this iurisdlpinn.
SI tare of a Hcan• Address /.( lA Ircmlon date
9no pP ( .'Z/1 iii'T pP
1t. or—an"Nor L�
. f
�/� ,yrsns.rr-.ire.✓ i`-ist /��9/ � 7
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Dote Plans I ByDate Plans ByNot-
quire Fee Started A pproved
s
BUILDING S
PLUMBING S
MECHANICAL
ELECTRICAL S
OTHER S
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Chad( Data NbBy Pdt or Al Check Dote 06t ate omer enpprovaOb„=red 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 a
Permit number _ SS 8:
Bpi ding
Permit issued _....... D 19 /y
7 Building
Permit Fee S
Certificate of Occupancy S ....... --
prod byte flDrain Tile
Plan Review Fee S
NOT ES and Data — (For department use)
VIII. ZONING PLAN EXAMINERS NOTES
i—
DISTRICT
USE
FRONT YARD
SIDE YARD ...
SIDE YARD —'
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use t L,**:'-=•'••111=1�:4
in E K g... •: •. PLi i• ....;zt4 5"s- "E EEeo:e ie
111 sss
an
19"
'3e �••• s:a #s9 ii�e:�ae• i„rtirias f n _ lite .s sigt ` 1a 51111ssa.
ull, + � assN
: Ea� a : ° :: ar e9 . s Ele_i5- aa "ss�ssil
as ? Na. ts � a• sea - s� rio•s
ti
id= us_nerirgignigiiiilitiMbilifigglistsi-1 gat
•
.� aa . E .s =r t : : •e n
• lliiiiisilli
breslanura s .I .
ryif` •ssss ir-F a .s �
•
hi Ii. Et E' hiM a us.sa :• =E .:iaa° .ss yErss eEis ouE ° :E :••ems ? sE _ .. _a, :: ss ;E
It. 4 ": . a ;r: ss ssa 1 — 1 £ .s x ,r,„- ,eNe sss
Iti
° ins ss j ` " ; �=4;ss ' 114 a • s
s
s
! !s • 7 o
/111: e �: ixts 4 •, ro > ° >. ss,1111
to s
1 14 tttil
iss
- sssss ais It o inetASE
. a � � a+
PI
7r
! • :s .
itrtEs: ss ,aI •� a ssa ,
x z fi , ss _ .0 1, amibim all 21:112113
rt
E tE: tz • —
a f 1.1si . i,* `t_ humI ss E i
i elibleatitatte
• 1 i> - F ` t it.
• • s =mint} ;1,3 it «. ;i `" ..
a, i } •tr . i �. *' - ,, s � .sR.t I r l b u' _. • ' • ng allgagi liM a . .
r . . .
''.