22B-016 (2) DEPT. FILE COPY
Zp
'j BUILDING
PERMIT VALIDATION
DATE, 19 _ PERMIT NO_ `r v
APPLICANT ADDRESS
(N0.) ET (CONTR'S LICENSE)
OF
PERMIT TO ( ) STORY ^ D WELLING UNITS
(TYPE OF IM ROVEMENT) NO. (PROPOSED SE
ZONING `1
• AT (LOCATION) DISTRICT_=._/F•
(NO.) (STREET)
a BETWEEN AND
'o
(CROSSSTREET) (CROSS STREET)'
O
a LOT
m SUBDIVISION LOT BLOCK —SIZE
0 BUILDING IS TO BE FT. WIDE BY FT. LONG BY_ C FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
Z TO TYPE USE GROUP BASEMENT,WALLS OR FOUNDATION
f (TYPE)
B:
0
LL REMARKS:
AREA OR PERMIT
VOLUME ESTIMATED COST $ FEE
(C BIC/SO RE REE J
OWNER
BUILDING DE
ADDRESS BY
(A • avit on reverse side"of application to be completed by authors of owner)
I hereby certify that the proposed work is authorized by the owner of record
and I have been authorized by the owner to make this application as his
authorized agent.
SIGNATURE OF AGEtJT`
ADDRESS.
(NUMBER) (STREET) (GT
APPROVEP BY TITLE
DATE t 9
ZONING PERMIT ?��-�
APPLICATION . r' 1~0. T:ot _
toning Crdin^ince S(,ction 10. Pile
,ner A. ;-Iic: t
'ddress � � '� /eJ 11a�?.res:
elephone � � >S' C7
This section is to be filled out in occordence t t?ie "Teb.- r)f Dir.jcnsionr�l and
)ensit y Re- latione:. (Z, ). AI TICLF, VI)
oning iT0C Lot Fro r.t Dcl,th c t c'•:f-
`::^x.n•lil. Min. Op.
>istrict
Area ;'idth Fror,t ..",Lde > _ Cover._ Space
Existin , _ �`T ��� '�
resent Proposed T :v
'lark the appropriate box to i.ndicite the rise of tl;c rarcol:
Q Idon-Conforming hot -nd/or Strt,cturc. Sl:ccify. _- ---.-- ----.------
r Residential M Single F^,iily liilit Ol ulti-F.:�iily
Q Dur,lex QOthci
Q Business
Q Industrial
Q instituti o-1_
Q
R�, ,il .r O P.U.D..Subdivision � �-
0 C1>>st" r,t 11
.er
[� Subdivision with ►,Ap1rov 1.-rJc;t ?� ntrir . ;i '
Q Plannirt, hoard Approvol:
= Zoning Po,i.rd Approval (Sl)eci^1 Pert:iit 1".ci: V•-.rinricc )
= City Council (especial Except_on G. 1().10)
ntershf,d Protection District Over.l.ty: (Z.0 . Sect. :.IV) 0 Y^
asking Space Requirements: (Z.(`. ,.sect. :'.1) Requircc 'roposc'
oading Space Reduirecientc: (Z.C. ect. 8.2) Require ropoced
,.inns• MO. Art. VII) Ye: _ r;o
,nvirormental Performance Standard::• (7.0. Art. XIII Quer E2!V.o
Plot Plan Yes ro Site Plan Q Yes C2z:J0
S. 10.2) (-r;. 10.c and 1'1,11
�.:'-iver Grai�tc,a: n.ntc Q
This section for OFFICII.L use orily:
Approval as presented:
=Modifications rcceesery for .1pprov:,1:
QReturn: (Noce irfnr.rr—n n t:e^ }r.•,d)
QDenial: Ro,:rors•
re of Apa �,m
,,licnt to �-�G` /6 ,.l�;hntllrE, �f i1, Officer
S i 6 r 4D to
For ALL buildings within Fire District and for other buildings costing$10,000.00 or more,plans
and specifications must be submitted to the Inspector of Buildings for examination and approval.
If building is to be moved give details relative to proposed location as for a new building
Application for Permit to Build
Northampton, Mass., ...... ...: C............»........19» :
To the Inspector of Buildings:—
The undersigned hereby applies for a permit to build, move, alter, or repair, according to the
following specifications.-
1. Owner's name .,t/�[..�%� .!tl. .: �. ..... :� .... ...............................................».......................................
2. Owner's address . ..... /�_� .: ... :. :.... ........................................................»....»......._..........................
3. Architect's name ....................... ... e ...........................................................................................................................
4. Builder's name ...................._.. ...........................................................................................................................
5. Builder's address ..........................,,..¢, +W....,,...,_J..,.......................................................................................:...............................
6. Location of Building. Street No. ............................................................................ .........................................................................
7. Is this a removal or new building............. ... ................_.........................................................._.,.............
......
8. If removal, from where ........... . "_=.........' :»..x! .......
......................._.................................................................._.................
9. What is the purpose of building ....:...........�r°y ,..��.�',, r�7` ......... ...-.-tAlwrlR'
10. Material of building
11. If a dwelling, for how many families ....Number of rooms
12. Is there to be a store in the building ...........,. ?.-.....................................................................................................
13. Size of building, No. of feet front .......1-,6....;No. of feet deep ............; No. of stories ».... .......
14. Size of ell, No. of feet front ......."!.......; No. of feet deep ......................-; No. of feet high ...........»..............
15. Size of Lot ..................j ..Za ....Feet Wide . Feet Deep ....'."'=.................
16. How near the-line of street ..............."_""......................................................................... ................................ .......
17. How near the line adjoining lot. Right............f, .........; Left......... ........; Rear...........! .......
18. Nearest building is............=........... feet in a....r,,. .».............=........... direction ......................................................
19. Material of the floor ............. ... ......».....................................................................................................................
20. Size of timbers, 1st .........'^....; 2nd ~�....,fe! 3rd .......................: 4th ..............................; 5th .............................
21. No. of feet span ...........»........t?..................................... : Distance on centers ....;. .. ...........................................»..
22. Will the building be erected on solid or filled land ..... ..... ......................................................................
23. What is the material of foundation...... —4 ..rif1 ......................»...•.;-Footing ....._.......... ..
24. Will the roof be flat or pitched .....7
... ....; Covering.....�M �
25. Heat; steam, hot water, furnace, stoves.................. e..................: Power oil burner ...............................................
26. Fireplace ...................._..................................................; Insulation ...........-.— .................................................................................
27. How many sinks .... Toilets .....'"::; Lavatories ..» ,, Bathtubs...; Showers"... ; Settubs..... .
28. City Service; Water .,�:x;�:'.... S.ewe .. ; Road Surface ...........................: Sidewalk ........................
29. Is lot on accepted st ket ......................_.... ». ................................................................................................................
/� o 0
30. Estimated cost (must be filled out) ..................... .....��, `�..G�l....t......................................................................».............
Applicant agrees to give the Inspector of Buildings 24 hours' notice before lathing or
plastering this building. This building will conform to the requirements of the law.
Signature of applicant .....i: ... .:c: :,f1,�:.1»..1�.»:... »..1..,..1::.. . . ............... .....................................................
REMARKS
.......... •.`. ............................................._.......................................
»....... ..........»....».......».... ........... ....... .... .............!.»...............................».......».................................»....»........