24A-027 (10) H DEPT. FILE COPY
Z D
BUIt.DING Ga
PERMIT VALIDATION
c/yq - -74,
IDATFJ �19 7 PERMIT N . ,r5.64_
APPLICANT C�'"7Lh't�f'! ADDRESS ?- !. -t 1
// / .� IS EET) (CONTR'S LICENSE)
NUMER OF
PERMIT TO /� ( / STORY Z_A��, DWELLLIING UNITS
. (TYPE 0 IMPROVEMENT) NO. (PROPOSED USE)
C.� J t$ ZONING / �1i
AT (LOCATION) / ,fr)...,,,geeii/ �,t� DISTR ICT �1� / 7
NO.) '� ST ET)
of BETWEEN , AND
0 (CROSS STREET) (CROSS STREET)
o,
LOT
d m SUBDIVISION LOT BLOCK SIZE
V BUILDING IS TO BE /C/� FT. WIDE BY 0
O FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O __—
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
X 0
/
a n�lT=LLLYrl'
REMARKS: t-�J
et
VOLUME ESTIMATED COST $ /l �1 FEEMIT, /� e
(CUBIC/SQUARE FEET)
f
OWNER
BUILDING E
ADDRESS BY
(Affidavit on reverse side of application to be completed by authorized agent of owner
I hereby certify that the prop so ed 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 AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19 .
CERTIFICATE ISSUED
DATE
,. BUILDING PERMIT -
CERTIFICATE OF OCCUPANCY
DATE__..A 19 PERMIT N �'f
APPLICANT :'." ..-! _� L't-lt''1'"+'ww'�C_s.�' ADDRESS 'f'�%r G -�t-e%`9
i .,.-.� ...• O.)) �"' (Sr*EET) ;(CON///TR'S LICENSE)
/f� � NUMBER OF
PERMIT TO - > ( ) STORY /2 DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING. // ff7,`� ,.,.
AT (LOCATION) ( DISTRICT"-
(NO.) (ST ET)
m BETWEEN AND
0 (CROSS STREET) (CROSS STREET)
m
LOT
a SUBDIVISION LOT BLOCK SIZE
m
r``
u0 BUILDING IS TO BE ,,�!'.> FT. WIDE BY 'i-` FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O .
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
2 r /J (TYPE)
•
0 REMARKS: ,.,? ..£ . -= ; .,,g�.,..1/'....�,, ,.�t •G�..7�^t..o..:.,.-y;a....-*v
Kt(K-3I ,_1 ,_ 1 ii ;-1*II ? 7 K Ktl . 7 tilKili ,-iii ?1K-Ii
AREA OR :I III NW :III1( '11111 :1111 .I'.1; )II III IIII :IIII )1I111 :1111c11 )1111 ;I IIIIIT Ail
-)1111 a
VOLUME . 7 Ail 7 , 7 . 7 `7 -` 1 l �1 � 'r1 kli =1 'r1 'r1 S
(CUBIC/SQUARE FEET) �'`�^l
'1111 Mu :1111 'I111 :1111 )1111 .1111 '1111 )1111 •1111 )1111 11111 )1111 )1111 )1111
V{"71,b!'/I IV T7l OrrvI,dTrIl 1V'f'71 tiT'II vT71'b'�fl,dT Tl,v T71 Ar I co T71 R7rTT1 bTTl A'WTI A'
OWNER s TO BE POSTED ON PREMISES
SEE REVERSE SIDE FOR.CONDITIONS OF C;ENTIICATE
ADDRESS
DEPARTMENTAL APPROVAL FOR CERTIFICATE
of OCCUPANCY and COMPLIANCE
To be filled in by each division indicated hereon
upon completion of its final inspection.
BUILDINGS Permit No.
Approved by Date
Remarks
PLUMBING Permit No.
Approved by Date
Remarks
ELECTRICAL Permit No.
Approved by Date
I
Remarks
OTHER Permit No.
Approved by Date
Remarks
OTHER Permit No.
Approved by Date
Remarks
VIII. ZONING PLAN EXAMINERS NOTES / - -
CITY OF NORTHAMPTON a
DISTRICT 4---- OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
USE /,�� �� NORTHAMPTON, MA. 01060
—`'�` PLAN EXAMINATION AND
FRONT YARD , ' , — 27 v2f" BUILDING PERMIT
Z
IMPORTANT - Applicant to complete all items in sections: I, II, III, IV, and IX. 0
SIDE YARD SIDE YARD J •
•� ' )
I. AT (LOCATION) 9 :2-- y ---1---eT- ///4i ✓
2‘,"---7,IL ^ _ ? DZONING
ISTRICT (left'
REAR YARD LOCATION (NO.) (STREE
1i
/ OF BETWEEN AND
2
BUILDING (CROSS STREET) (CROSS STREET)
NOTES /7-1/'U LOT
SUBDIVISION LOT BLOCK SIZE
Vr
II. TYPE AND COST OF BUILDING - All applicants complete Parts A - D 'i
XI
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
m
1 I I New building Residential Nonresidential
94 Addition(If residential, enter number 12JOne family 18 Amusement, recreational
of new housing units added, if any, 13 I I Two or more family - Enter 19 Church, other religious
[IX. SITE OR PLOT PLAN - For Applicant Use in Part D, 13)
number of units- - - - --> 20 Industrial
3 I I Alteration (See 2 above)
14 I I Transient hotel, motel, 21 Parking garage
4 I I Repair, replacement or dormitory - Enter number
5 I I Wrecking (If multifamily residential, of units - --).• 22 Service station, repair garage
enter number of units in building in 15 I Garage 23 Hospital, institutional
'3' < •.-a-- +:I...' .,�...r w." Part D, 13)
1 1-4-1'a t {7 e:+--,T,")1 . { -r +- ' i- 24 Office, bank, professional
} ¢ r p i � 16 I Carport P
'� ..5, +. �* i -`r-a-a-a� i«, #,a..� - a'`"-s. a- I Moving (relocation)
- Public
�� 44 t $ d " 4 � Foundation 17I OtherSpecify 25 P b ' utility
,,., >.._, , ,r..m . ,t ,. ., 7 I I oun anon
6I It.
26 School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
•
8 At Private (individual, corporation, 28 Tanks, towers
nonprofit institution, etc.) 29 I Other - Specify
t dS 1', 9 I I Public (Federal, State, or
��t a a ;-3 ..-a, -��`a�, --e--'�-�'� -4-"� ``;+- r. .a _: -ta k a" +.a-a«�.{ -�-¢-es -+-- � ». -;- -+.;. # �
f - r - r3- �i , , � I i 77r"-, - �s r local government)
} yy
'1 -"s 1 ,"..i. 411 11 1 -4 �vt1 i ' m 1- ' 1 `-w ,r ,. — a -s 0. tA--: --:-;-- p-. > 1i--r -t,. '
��§r ter+ ? 411411142 t . ,� � . (Omit cents) Nonresidential Describein detailusefood
. � .: w ;� � f r1 �° �� I -3 � �-,-_- s "� C. COST 0 � s sid olio) - proposed of buildings, e.g.,
processing plant, machine shop, laundry building at hospital, elementary
ege,
hial school,
ng garage
or,
10. Cost of improvement $ / �� deparrtl, secondary school,ment store, rental office)building, office building atl industrial f plant.
w..; n�.. <-d „��, t � ,_, . i ..:.;- � ,_,.,v�- ,-+1 -5-�;�-e :---�� _'. 41 - p :?�--1 �.�-, mpr
t. _, >,..la' -� -.... � ,� � �,r-;-r ;+ -; r � -r t ( t ,; -;r;- j� To be installed but not included If use of existing building is being changed, enter proposed use.
a
.a M.a.•aa.aw.aa.a U'es.`aaaaw.a. ^ U; ; ¢ .P+d,ems igaggemims t"+ r U.S+ theabove
.aaaaara.warr•.a■•uaaawaaaa•la.w■aaU' .... ;-;+,`°.. ,y,. ,.' MP' Y in cost
aM. •..a.a.».a•■ .•a. aw.a. 9,,._. -1-
.w •.■r'Uaa.UU....m•u awaara.al■a.a UU.aar.. �-x; a. Electrical
L
•w.•r.M w.a••r.•r.aa■• .aa ..w.a rw■•.w.USU. ■. •.• a a . I T Z r- 4-1 I
•.aaw•a:aa Mara■saaM a:rawar .••..S S...•.r.w■a■.■■.■wra■Mruln■.a..a�M ■ aaa•a _ -„ +,„ N "1-
.. • •Ya..aa.•.M■.!. awa■t■r■H■■ta.aar=
" " !!a Ise•••a .as. ••a•• a •aa■sa■••w.ar • r .¢ . ., `,,41
.. �. li, :'�ai: € z, .� �} ra � - a-eatm r='r b. Plumbing
nei
ogrartow
la:I■a'a� :2i. ::::•il:aaees•'.a•iaa•i.+S'i.US■U:i=eee•iSUU' w eesU T. ce. - 4 ,�N-arms •�•[pr� a� • r e c. Heating, air conditioning
1■..l d cores ■ 11:: ■ as ��ii # ►
. . INlu1unu a!!!II1I.IIN!lllu ■u! . nt>• : :'■::::_ iC ::;v"aaaaaa'aa=i
• r`)1°a(i�iY'::Wig EN::::::::::Ei::::il::2:::w wui saii■wi:::i ittuti�Giiiilni'1;tWiliWl ti='�w•a- ■Liis1M1'ii.W ..:0JIt•��a ilir/� FIY: ::":::::t
cr ;t •tt. .f MI ` �■ .M.a ■ ■ •• ra a ! d. Other (elevator, etc.)
_, �, ilu ;•r 1 ,t � * 1 ''�G' a �� iiiiiiiiiiiiiiiitil---711111iftr:
aat•r ' �� 'isF'.. 11. TOTAL COST OF IMPROVEMENT $ �i G�t �--31::::::.".."a1�UBaea aaaalllalliiiii ai1U•iiiia� •U'S••IUBU : •• U , Hill ti #' III. SELECTED CHARACTERISTICS OF BUILDING - For new buildings and additions, complete Parts E - L;
sauu.a a. wa. •nrrw■..au.....M.......a.a.M.•aa..MQ..... aa■MwMar}aa..•■.• ■ ■•.aa■....•M■a■t a■s_.aaaw
aar■•M.aa.a.aa..a•.r.■ae.:: ia_s.:m:'a' �..:;UBaa UB;asUB•e5 5•.aaa - for wrecking, complete only Part J, for all others skip to IV.
I titii:e:l:1 u1:!!tllttiiciutti`:tt atiniu:lirnilituptautitt ummu II ummu IIsra .uimuniol.,. u:,lllsiu.un!!!!il
t urn! en 1 l . a E. PRINCIPAL TYPE OF FRAME G. TY E OF SEWAGE DISPOSAL J. DIMENSIONS
' •ti .. [11211111
a 48. Number of stories _
.IC■.aw.•.w••a»•»ua.■aru■rra. �arar •mow 34a-Masonry (waft bearing u tt�oTprivate companyawwaaf■ ■OOM.w.•..r•.•..r■•rC' ..■.MMl.aa• sw� •ilri ai .i � ,ji a +. 1a. • • •1 Y l ,���Ir�■: > ta••� f _ __ _..____-. _i ! !BI i lii ,j _ M • r 49. Totals uareFeetoffloor area,
! 1i OI ��h 1 1 hi (! 1iiiflhii0 a 31 I I Wood frame 41 I I Private (septic tank, etc.) 9
t '! '! ! l _ 1l!! 1tI !ul l i !/• l 1111
• . TT l all floors, based xt r or
, .T. l a .. • u ■■■ r �' • ■ 32 Structural-s+Wer, �� ^"'�""" dimensions ... .. .. .
;I � I 33 Reinforced concrete H. TY E OF WATER SUPPLY 50. Total fond area, s . ft.
1111
111111111 III
r 34 I Other — SpeciJy 42 ublic or private company
!r�, r� •�awrL'! UtI • !.4` "^ra'r�a't""ft!S�sM • ••■ �a I a ■ a.aI ..as
'y a w ■n•• • I 43 I I rivate (well, cistern) K. NUMBER OF OFF-STREET
•SuSI•US*i:. la�i�liara f r a I ... M. aaia�:a1000I ;;;;;M:1ralw5ati■.1l■Saa• a.� w i . a±lw.r oda • •
`Iulua!!I=l!!s!ass:!iili t !!I ! lIii1lainnmaluulllllluill!!!Nl:aaiaialllutllliiiu=i-u riiiI:� i il�11!!1iItl!!I!l:t$ PARKING SPACES
A...aa.•YaaaM.wa•...\.. •■aSOSOSO l•M.. a.4rpr.•.A.•aMMMt SSISSO aa...
!!l!!lI!!!!!!a!l!1!!l!H!l ; IrffillilniiMMUMIMMIIMUninallinaMPNIIMINNIMICININSIMI:�ii # � � i = ' ` )� � ;i1�fl �l� ��'�f�l =� F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL51. Enclosed
SO SOOar•a! ■earaaa'I . al �. •ri if .. ■.IYri wwaara'aaIa......aa SOar•u a. YriUB slMwla.�.a6iw� • aryua �rraIr�itrn al.ars 35 Gas Will there be central air 52. Outdoors
=ltt tliMOOS
1 111:11411*la!!llt�111R111 IR ...•..i�ii:a un u li ::?eI* IM•1 11u:OS ha.inc ti�BUB!!I!!I!l1IGa 36 I oil g?
s • . ■■Ma awa■SaaS ..a. ! a...■.w■IM conditioning?
liiliiilili• I:li! IIII>$illlrtll:IllSSN1«tttlg11i1:llimi�usultiwtltllttl� :lslrf�ir�ill �!1isfullis t teI:ottMrliNllfllem I 1Electricity I I I I L. RESIDENTIAL BUILDINGS ONLY
�• 3744 Yes 45 No 53. Number of bedrooms
aa..alaawal ei RS SI.a.Ja..r..a..•aa::aa.RM...Ma.~a •Uaaiw�.s ■a. ...w■awa...a.k.UBC.::::::a 38 I Coal
:s:l::. •21aeas:a:=•11..LU aaU. :::UB:RU'a.. .aaa.MMOOOO:' a.aMaa AM.J.:.r .awtaw -■ .M.■ .Ma.�M■. ■ a. •..
a Mww#tN.I .IF..a. r...E-p_ ,. I`�, `..4.... _______ _„4. ., - s-„`�,..,-.-�'F „it_ .I`aa
I. k ... _ • 39 Other - Specify Will there be an elevator? 54. Number of Full
e-1 46 I I Yes 47 I No bathrooms
Partial
BOCA FORM APEBP — 669 CI969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
NOTES and Data — (For department use)
1.
Owner or
Lessee
Builder's
2. 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
1
l� 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
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 FOR DEPARTMENT USE ONLY
Permit number
Bui lding Use Group
Permit issued ,t.t.). 19ZQ
Bui Iding Fire Grading
Permit Fee O Live Loading
Certificate of Occupancy Occupancy Load
Approved by: -
Drain Tile $
Plan Review Fee $ _
ITL