23D-078 (2) I,
I r
• ' ' `'4 `,''`'� BUILDING ,• _,
4,4104ti ,1r . 0 /0 t 0 0
CYO r, PERMIT a
/ d3 - / [J VALIDATION
DATE 4 19 C_ 4 PERMIT NO. 3cL3
APPLICANT f DRESS f 0
td. 0 (NO.) (STREET) (CONTR'S LICENSE)
�o�J atcrw NUMBER OF
PERMIT TO r (_) STORY DWELLING UNITS
(TYPE OFPROVEEMEE NNT)) NO. (PROPOSED USE)
AT (LOCATION) // 1/ �/L tii /a<Jr/" ZONING
DISTRICT
N .) (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
/yJ._,,, (-\ (TYPE)
REMARKS: C���.4J - le�+d'bt.A.AA - , '- .,
n , r, �
AREA OR VOLUME ESTIMATED COST $ (��, ' PERMIT FEE
I ') (CUBIC/SQUARE FEET) /
OWNER BUILDINGff DEPT. ._ I 777
ADDRESS BY
WHITE - FILE COPY • GREEN - FIELD C PY • CANARY .• APPLICANT COPY • PINK - ASSESSORS COPY
1
41296.9- �. - r� 91.4106aa1/46
BUILDING
[ Ns
0< (i•
/at 0
) 4,41,44) .r : 1L, a/a�v PERMIT
1 •�� at D * ! k VALIDATION
'1` �/���JD��ATE �13- a RM I T NO
APPLICANT �!G V DRESS
(NO.) (STREET) (CONT R'S LICENSE)
NUMBER OF
- PERMIT TO •Il{ Qat., (_) STORY DWELLING UNITS
(TYPE'OFROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) !P //JJ G ZONING
DISTRICT
(NI) ISTREET)
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
REMARKS:1,411 � f � //��'•�'w�9 r.
f�� L 0-"""0� 74.-4.4„.....„7_.
AREA OR 614 PERMIT $ /0 N 0
VOLUME ESTIMATED COST FEE
OUARE FEET)
OWNER Q BUILD!
ADDRESS ( "di��'• BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - A SSORS COPY
• , N.. CITY OF NORTHAMPTON k
� ri r MASSACHUSETTS
VIII. ZONING PLAN EXAMINERS NOTES —.�`)- )i�,1'1
•.1•1:_d(L,ettiPA .4.4.....ate �J `• �(1_. OFFICE of the INSPECTOR of BUILDINGS
F.
DISTRICT q
Page -1 Plot 7 APPLICATION FOR
USE Z
INSPECTOR BUILDING RPERMIT
D
FRONT YARDz
� )
IMPORTANT - Applicant to complete all it ms in sections: I, II, Ill, IV, and IX. O
SIDE YARD /S1-'d SIDE YARD firt...d //!/ '� ZONING IRe
I. AT (LOCATION) <0 (STREET) DISTRIcY� '
' LOCATION (NO.)
REAR YARD /�f OF
��r """ BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
NOTES
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING - All applicants complete Parts A — D -I
73
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
m
1 I 1 New building Residential Nonresidential
2 X Addition(I/ residential, enter number 12 ��/ One family 18 I Amusement, recreational
of new housing units added, if any, 13 I Two or more family — Enter 19 I Church, other religious
IX. SITE OR PLOT PLAN — For Applicant Use in Part D, 13) —
pp number of units— — —
3 I I Alteration (See 2 above) 20 Industrial
14 f 1 Transient hotel, motel, 21 I Parking garage
4 I I Repair, replacement or dormitory — Enter number
. ■ 22 Service station, repair garage
• a 5 I I Wrecking (If enter number multifamily nrbuild titian of units — --?► P 9 9
g 15 I 1 Garage 23 1 Hospital, institutional
■e
Part D, 13)
_ 6 I I Moving (relocation) 16 I Carport 24 I Office, bank, professional
al..■was.aa : f 25 Public utility
: 7 I 1 Foundation only 17 1 Other — Specify `
■ ■ F 26 School, library, other educational
::a .aaOOOosei::: 41'� /�-l r/�
uo..•:.:•aa. .: ■ B. OWNERSHIP iii.2:tii
27 1 Stores, mercantile
■ 8 X Private (individual, corporation,
28 I Tanks, towers
roar nonprofit institution, etc.) 29 I Other — Specify
it • 9 I I Public (Federal, State, or
aai : local government)
:: :: C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food
auo•.u•u■: ara■.aaa+r. : : 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.
'a.. •.•■i : : To be installed but not included If use of existing building is being changed, enter proposed use.
in the above cost `• .
•aa..::::•• s::ia:! ! : : a. Electrical LgjLA
:a::l:s:lsa■a.a. ■ •• U
HNN■p•.::•■ :• : i ::
.■■... l:..■.! •• b. Plumbing
••::raUMW • •• •• ■ c. Heating, air conditioning
Iaaae.•!•::r:l ! as=■
S:!li:p::Z•aa■. :•:':::l:■:s: _ : s: d. Other (elevator, etc.)
.ua ua
la....:.....:
::::! s::::l:L:l::::::::::: : ' 11. TOTAL COST OF IMPROVEMENT $ Yrrei
::::::a:::Na....aaaa=la.•aa.l...aasa:! ! _ ! III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
:: :::::::...■ !l a _•'_'•_•'••: : :: ::: for wrecking, complete only Part J, for all others skip to IV.
:::: •::::..: +. • . : : E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
!ll..l.s.: l ::: :
s::ill:l:s:l::::: =•n= a•a+ = 48. Number of stories
: l: l : : '•: 30 1-1 Masonry (wall bearing) 40 I Public or private company ���
:• !U•#: `� :: !! I/ I 31 Wood frame 41 Private (septic tank, etc.) 49. Totalsquare feet of floor area,
••••:::••= ii• g■ :l :_ all floors, based on exterior /
.1.::::!•!i!l•::l:::OOOO ii:::::::� : .■• :UM :: •a' ::::::::■=a.l.a..;l • /7"r'5tipj-c3'
�it: l:s.•aa..a. ! ssla:asan: • : o■!.■=_:__ 32 Structural steel dimensions
� _ + •a + a� al.a+ •■• : ua'a. 33 I I Reinforced concrete H. TYPE OF WATER SUPPLY 4"
t :•!! .: : : :a a:u. 50. Total land area, sq. ft.
3■ilssass::■■:l:o: : _ _ ! :!! :• _! •a■,: 34 1 I Other — Specify 42 K.Public or private company _
■ :a■:::::::::::• :■ :..•• .■a■ • •• + 43 Private (well, cistern) K. NUMBER OF OFF-STREET
=::tail••::::::• • : s:.=u.: : :lu..: :: : :::■■!'ri■ln:. PARKING SPACES
.• .. • .s::s::::::::::::::: :•••:::. :'
•:.::1:::•:■ya:...ul:::: .l:::■■r�•..: ::! :s.• :!l:::::s : ::!_ 51. Enclosed
•:.. ••■+.l •a::l:+l::: ! • : •. • :::..•+••■.: ■ F. PRINCIPAL TYPE OF HEATING FUEL I. E OF MECHANICAL
�assaa ...asaaae.■........a■a.s..ls::.:::as! : s:sl.s::+�i:: s
:l: 'sia$$iiiii : : • •••aa as:::sal::::: :::: : a a•■• ■ .+ a. ■..aa...•a:i::::a.u...
l:: ■ • !l:::! ::l•+. •• a■:aaaun: r • • .o s■:+:a. :as: +: • .. ■ a.aa aa. : 35 I Gas Will t re be central air 52. Outdoors
:• : ::::.:s:lal :::::: :11 l:::.a•a::sa:ass...... :::::: !a:!!■:l:al•::::l:::::s::' il■a:la:.a:l:u:::.u.:a•.:
■• • • .. • . •■ • ■ 36 Oil conditio 'ng.
l::•'::• ::: 1::•,�Will■ :•••: :• S Z••g:.l::.:: tilem: . .r: ■;:::::•:t1•: L. RESIDENTIAL BUILDINGS ONLY 3
i :: • • : .ii :.::!•::l: • +ua:i•:: ••••••a:s::::: • • ■ . a 1I■S: • • • • n n■ 37 Electricity!lli :!l.:S.l.t: l::lS!■:l:ill! :■a: s.■nxaa.las.l:::.l:l:l■:ll.::l :.■•:■::al:.l.lu:•terra:tu.:.•a■u• I 44 I Yes 45 No 53. Number of bedrooms
: ::::: :•.::: :1q seas ••.. .r '•:::•••'•••::::l:::: :::::•l•••r•:illi ::o r :� :l :::•.ls:.:a. 38 Coal
a....!pNM 1n:ll::ll: F�:s:is$ nsgl is �I.. : �$ •=■••l• ■:arils !!!!:ia:::• s..:ai::mslll::!!!lien.....:::g : �':.:: I I /'
ISiiIS _ __Illllaill:ill:141:: ! 1!� nmeeManigiallinill aiM R IIIIi=l::::::::::::::::::::::'•!u•■!! a.,...°••'•: 39 I 1 Other — Specify Will they e an elevo r", Full
54. Number of
46 J Yes 47 o I bathrooms
Partial
BOCA FORM APEBP — 669 C1969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
IV. IDENTIFIC-T10P1 — To be completed by all applicants ! • ' . SO. i4t)•J .
.
Name Mailing address — :cumber, street, city, and State l ZIP code Tel o.
1.
167 -/ � �, a VLC)40 NOTES and Data — (For department use)
Owner or
Lessee 64 ;,
Builder's a%?. .3 h� ...�/ i a
Contractor 2.
I License No.
I • (Wit
r
/4246a/
3.
Architect or 01?)"434
.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.
S'.natur- of applit Address Application date
724 00 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
•
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 aj .3 FOR DEPARTMENT USE ONLY
Permit number (�
Building. Use Group
Permit issued S 19
Building • Fire Grading
C Permit Fee $ 0 Live Loading
Certificate of Occupancy $ Occupancy Load
pproved by:
Drain Tile
9
Plan Review Fee $
TITLE