23D-027 (5) DEPT. Of. BU'ti%DING INSPECTIONS BUILDING °
j; 212 Main Street Xa 1, 0 0 O
-� > Northampton, MA 01060 PERMIT
:030 - ',17 VALIDATION
e!L41
If
9,A4:tiat'
ATE ' R19 L Y MIT NOL
APPLICANT � ADDRESS :hi--
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO "✓ `ICi 4 NUMBER OF(_) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO.
(PROPOSED USE)
AT (LOCATION) ` �� '^� ` D STR CT:09. ZONING '1/28
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE - - - FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
� (TYPE)•
REMARKS: I �&1_��1i t) 01 21 . .f.:oi.i)
AREA OR It VOLUME ESTIMATED COST $ 5'O O —! ;WIT $ 2.0€00
A , Q` (CUBIC j'(UARE FEET)
OWNER ,'/ ^ '�`
� BUILD! . !eve - �, ).C...4,
ADDRESS ! 6 l BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pie' P
- 01S CITY OF NORTHAMPTON
VIII. ZONING PLAN EXAMINERS NOTES 9A MASSACHUSETTS
,�
• .le4= )i„Irt
$ t� �i )►.• rtl OFFICE of the INSPECTOR of BUILDINGS
DISTRICT • --Ai./ '- O
JVow ..
_` .� Page Z D Plot ' APPLICATION FOR
USE
INSPECTOR ZONING PERMIT ANI
BUILDING PERMIT
FRONT YARD
Z
IMPORTANT — Applicant to complete all items in sections: I, II, III, IV, and IX. O
SIDE YARD SIDE YARD L(v S �'LM ZONING tig 3
I. AT (LOCATION) DISTRICT
REAR YARD LOCATION (NO.) (STREET)
OF BETWEEN AND
BUI LDING (CROSS STREET) (CROSS STREET)
NOTES
LOT
SUBDIVISION LOT BLOCK SIZE
VS
II. TYPE AND COST OF BUILDING - All applicants complete Parts A — D —f
73
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
m
1 I I New building Residential Nonresidential
244 Addition(If residential, enter number 12 KI One family 18 I Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 r Two or more family - Enter 19 Church, other religious
IX. SITE OR PLOT PLAN — For Applicant Usenumber of units- - - - -0. 20 Industrial
3 I Alteration (See 2 above)
: 14 I I Transient hotel, motel, 21 Parkinggarage
_ 4 [ I Repair, replacement or dormitory - Enter number g g
: _ ':::: ofunits - . . 22 I Service station, repair garage
5 I I Wrecking (1/multifamily residential,
: : enter number of units in building in 15 [ Garage 23 I Hospital, institutional
.•• 9
:Nu••■N••■• _ : : Part D, 13) 16 I Carport 24 Office, bank, professional
:MinM •••N•N _ 6 I I Moving (relocation)
i :::: • U _ 7 I I Foundation only 17 I I Other - Specify 25I—I Public utility
•N•• _ : 26 I School, library, other educational
••_ ntu ams::::::: :
N •u :
B. OWNERSHIP (��'Oa[J�•��^ �-•r114t 27I I Stores, mercantile
_ ; 28 I I Tanks, towers
r I Private (individual, corporation,
_ = 8 b< nonprofit institution, etc.) 29 I 1 Other - Specify
_ r 9 I I Public (Federal, State, or
rear , _••••= II local government)
: : Ile
: : i i C. COST (Omit cents) Nonresidential - Describe in detail proposed use of buildings, e.g., food
_■••• : processing plant, machine shop, laundry building at hospital, elementary
r •••• �� 000--
r.■■N■r.■....m• 10. Cost of improvement $ S school, secondary school, college, parochial school, parking garage For,
••••••••• •,. r••:• _.N■ department store, rental office building, office building at industrial plant.
_"••••_•••■• �•I- r• r a _ :c • To be installed but not included If use of existing building is being changed, enter proposed use.
""''f'' = =. - '.d:,•�■r in the above cost
I.
mow:-
••==o•a.:.• .••G=...• ---- - a. Electrical
11111POSillai Us. : ••A A,. g a t 0 al SO
All
N•�••N= :: ass : r,Nr■r,ur.■ ee
■■ b. Plumbing
AM.:::::::: i 2 II■■ Nu■ c. Heating, air conditioning
ULU.... ..::......■■:::i::::•ii:::i : _ ' d. Other (elevator, etc.)
• •• •
_•`_=••••."L.' a •■•• •::::::i•i:=����_ _ :N � _ ' 11. TOTAL COST OF IMPROVEMENT $ 6.-0 el� —
=". ..e...:....t'. _.."_:_:!_:::::::::: : III. SELECTED CHARACTERISTICS OF BUILDING - For new buildings and additions, complete Parts E — L;
::•■•. :••■•••'i■•.■•••••H,:Yr." S IT �� =Cirf' ::
_'__'_"__ •• ': : i•Inele = for wrecking, complete only Part J, for all others skip to IV.
:•:::::::: •'••''_'•"'_"' E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS ti
••■ r•..• .ee■■ ■■ 48. Number of stories fL'
' ••_ : = 30 I I Masonry (wall bearing) 40 L l Public or private company
•••• ' r 49. Total square feet of floor area,
:::_:::::NNNa:i: =••r li ._--_ - _ ' : 31 V Wood frame 41 I Private (septic tank, etc.)
= all floors, based on exterior
E_==:::::: :a=:i=::::::_::::�::S:S: ::C •:s:: : _: _"'•_ = 32 I I Structural steel dimensions
_■•_ _sil MI glORss••• :::: : _ : :: _ 33 I I Reinforced concrete H. TYPE OF WATER SUPPLY
EIE:ass:::::: 3 : : : e..... ::::: : Its '! _ _ 34 I Other - Specify 42 Public or private company —
50. Total land area, sq. ft. —r
•::__
• ■.,- 43 Private (well, cistern) K. NUMBER OF OFF-STREET
3 :■::•: ••:• •■•a• _ : : _ iN•:::•:::: :••:: :•': [� w I:::: • ::: :.N•S : •N•N•■ ••■ ■ •• •• PARKING SPACES
=■•N:�•:::s...:��:! :::::::i::::::! ••: : : :: : Y•:::: r• • N•NN•■ • • ■••• ■• gg• •• •■ •• • a N•••!•
:•: :N••: :::$ • ■a•� :•a':ri■'iu'rin : :Za:.a a a � a•=• 51. Enclosed
: :: sow n as:; �11 RI 11 ': :s s = ••• " sssus::s:8 s s...Ns: ::s:ns: :
ss • • is •. • 1 li1s` iS' :ills •ss ::
■•• NSN••N • p.■■;� :■■ • ••■ • • •••• �• .. n+• • :•••• ••� F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
i:i L ! •"l•:::s::s li•• ••:•: ::::::::i: ' riser :•.. :: a • ; s•; ::N: :•:•::: •:H , S•• •N::::::::::::::::::•••: ���r�
u: : : iii: : :: 's=i • �I•• •i� u ::_ • •• a: i n�• i• • •4 : __ 'i�i:' •::::•::l:::: ::• 35I�I Gas Will there be central air 52. Outdoors
•� ::::::•!ii i_ N:!i:�a:•::!•� •�:13: o: ill .:p: ulU�r::::ii:::ia•::N:•uaa:.. a... aia:: tionin
:ii' • :�i s:::$:"• • •• i'��i -ii''•• ::•• i ' ••""• 'i'' : : :: i:: ' �' : I I Oil g L. RESIDENTIAL BUILDINGS ONLY�iis gg s :'::::::i:: ::' a. . . •:::•••Sara • ■:::a• • .. . . i:::::•::�:_: .::... 36
' y• l�:: ::: : :rZii::r ' ■ ::■Qa_ • ::r:: : :i.::: :: .�ii:iirs•Nn•iiiiii:U8::##U 8 :1•i•i•iit u::::m�■::ate:■■•:i•• 37 I I Electricity 44 L Yes 45 —I No 53. Number of bedrooms rtun ss utElN_�Ni IIs si.ar.N� i. . ..N$•.. N,�11.• i �s�: i.:.s•■� I8:, s• aik.M•ae: m.••s == fit::s::::: :s _ 38 L-i coal —
�� ••• • �•����•�_r� '•a"• '•��••• • • •••• • • • • "' N 39 ICI Other - SpeciJy t�'� Will the be an elevators Full /
i7•to ;np•p•••m:.a:�i�•i=.88;ll! rSR u :::ammul ■ROSI B88lr8 :Mtn:r::•#:::�.�•s : ':•a �' 54. Number of
4 - Yes 47 ' I No bathrooms
Partial
PI{i•IyNyTN P __
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address - Number, strut, crts, arid Ctate ZIP code Tel. No.
1. /iA'/srM- mace k, // �i- / L , s - A oe 0/1 T� An� O`v&� L-sT (oa (c NOTES and Data — (For department use)
Owner or ( /�'LG! T�OC/ L. ��/ /'J
Lessee
� w Builder's
L.
`cyyL�J 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
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
/
U ` ✓ r�/-
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
1
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
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 FOR DEPARTMENT USE ONLY
Permit number
Building.it qedlet-A, / as" Use Group
Permit issued19�
Building Fire Grading
Permit Fee $ 2..c2 00
Live Loading
Certificate of Occupancy $ Occupancy Load
Ado d by:
Drain Tile
Plan Review Fee $
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