37-077 (19) DEPARTMENT OF BUILDING INSPECTIONS
FIELD C PY
212 MAIN AREET
NORTHAMPTON, MA. 01060 BUILDING
�'7_0 7 _7 44 - 3
PERMIT
DATE October 28. 19 80 PERMIT NO. 652
APPLICANT John J. Finn, Technical Superv. ADDRESS 186 Main Street, Northampton
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO New building 1 ) STORY tower & assessorybuildingNUMBER OF
( DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
Florence Road ZONING
AT (LOCATION) DISTRICT SR
(NO.) (`STREET)
rn BETWEEN Westhampton Rd. { 66 AND Butts Pit Rd.
'D (CROSS (CROSS STREET)
.
L
T
a SUBDIVISION BLOCK SIZE
E 5.573 Acres
m BUILDING IS TO BE ,'6,-4„ FT. N\Bj(T FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
toO
Z TO TYPE USE GROUPBASEMENT WALLS OR FOUNDATION
E (TYPE)
cc
L? REMARKS: C.A.T.V. Electronics Building and 150' tower
Masonry frame building, electric heat, central air conditioning.
Structural steel tower
AREA OR $
VOLUME 348.4 ESTIMATED COST $ 12 PERMIT 39.00
(CUBIC SQUARE FEET) /.)
OWNER Continental Cablevision of Northampton, Inc.
LDING D
ADDRESS 186 Main Streets Northampton, Ma. 01060 B T,
INSPECTION RECORD
DATE NOTE PROGRESS - CRITICISMS AND REMARKS INSPECTOR
mjEPARTMSMT OF BUILDING INSPECTIONS CERTIFICATE ISSUED
ow
212 MAIM S DATE
' TNAMPTON' % ' 01Q60 BUILDING PERMIT -
44 - 3 CERTIFICATE OF OCCUPANCY
DATE October 28, 19 80 PERMIT NO. 632
APPLICANT John J. Finn, Technical Superv. ADDRESS 186 Main Street i+lorthampton
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO New building ( I _) STORY tower & a5SCSBory building DWELLING UNITS
(TYPE OF IMPROVEMENT) NOS` (PROPOSED USE)
ZONING
AT (LOCATION)
Florence Road D STR ICT SR
(NO.) (STREET)
rn BETWEEN Westhampton Rd. (Rt. 66) AND Burts Pit R.d.
'D (CROSS STREET) (CROSS STREET)
al
a LOT 5.593 Acres
m SUBDIVISION LOT BLOCK SIZE •
VO BUILDING IS TO BE Zb9-4I$ FT. WIDE BY 219-4*, FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
co
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
M (TYPE)
M 6py II REMARKS: C.A..T.V. Electronics Building and 150' tower
Masonry frame building, electric heat, central air conditioning.
Structural steel tower y�,,,.��,...��.,�.,��.,�,,I
019UI '%,7 : 7 �� ;-4 KEE 91111(1�111417L1IIi SIl1 l Kiii K-� '; 71 K�IC
AREA OR 'f f•a $IIQ1:IIII :IIII( ;)IIII :IIII 1 11 •IIII :1111 ;IIII :)IIII •)IIII :IIII
VOLUME 148.4 K 7 K-� • 7 ; 7 • Z( ....: ; _ •-El •El r ' K27 • `,.~�C��'1•ii 1
(CUBIC/SQUARE FEET)
III :IIII :IIII :IIII )1111 :IIII :IIII :IIII •IIII •IIII •IIII :IIII :IIII :)IIII :I)II
L�f
ar-ri1 ,111101T'TI bT•TI)[Y2'flA"TIYT IfI R A I A'TT'TI •c T'Tl,kr T i6'TI 11I IO,TT C' O A'I R1TI T-TI r1Io
OWNER Cantinantal Cablevision of Northampton, Inc. TO BE POSTED ON PREMISES
SEE REVERSE SIDE FOR CONDITIONS OF CERTIFICATE
ADDRESS 186 Main Street, Northampton, Ma. 01060
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
Remarks
OTHER Permit No.
Approved by Date
Remarks
OTHER Permit No.
Approved by Date
Remarks
DEPARTMENT OF BUILDING INSPECTIONS t- utt'l. FM COPY
2 MAIN STREET zD
' NORTHAMPTON, ,MA. 01060 BUILDING 2a )0d 4391 /e-da-Fd
44 - 3 PERMIT VALIDATION
DATE October 28, 19 80 PERMIT NO. 652
APPLICANT,Tnhn J. Finn, Technical Superv. ADDRESS 186 Main Street, Nnrthempton
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO NPTpW h1141(linp (�) STORY tower & assessory hill 1 ding DWELLING UNITS
(TYPE OF IMPROV MENT) NO. (PROPOSED USE)
ZON ING
AT (LOCATION) Florence Road DISTRICT SR
(NO.) (STREET)
m BETWEEN Westhampton Rd. (Rt. 66) AND Burts Pit Rd.
') (CROSS STREET) (CROSS STREET)
en
col; SUBDIVISION LOT BLOCK SIZE 5.593 Acres
a
O BUILDING IS TO BE 16'-4" FT. WIDE BY 21111.
4" FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
re
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
f
O: (TY(TYPE)
0 REMARKS: C.A.T.V. Electronics Building and 150' tower
Masonry frame building, electric heat, central air conditioning.
Structural steel tower
AREAOU ER 34R 4 $ PERMIT 39.00
VOLUME ESTIMATED COST F E
(CUBIC/SQUARE FEET)
OWNER Continental Cablevision of Northampton, Inc.
BU DING DE
ADDRESS 186 Main S*rePt, Northampton, Ma_ 01060 B
(Affidavit on reverse side of application to be completed by aut ized agent of owner)
i
ft
r t _
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 AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19 .
•
3 - - CITY OF NORTHAMPTON
• 9a� r� . 4 MASSACHUSETTS
VIII. ZONING PLAN EXAMINERS NOTES • _ wl ,) �'i
���.
• ��.,),_ 0 OFFICE of the INSPECTOR of BUILDINGS
DISTRICT J"vs '
USE r 1 =-"- - Page j� Plot ZONINGICATION FOR
��� �' PERMIT AND
t� l INSPECTOR BUILDING PERMIT
FRONT YARD
Z
IMPORTANT — Applicant to complete all items in sections: I, II, III, IV, and IX. O
SIDE YARD SIDE YARD
�/ / ZONING
I. AT (LOCATION) ` /4/P/ICC. �O. DISTRICT
REAR YARD LOCATION (NO.) ((SSTREETT)) �� L
OF BETWEEN airs/Xez,n,T0n ,I K r (� 6> AND S-/rT.�L lie 0/.
NOTES 4BUILDING (CROSS STREET) (CROSS STREET)
J ��� / �- � SUBDIVISION_ LOT BLOCK SIZEO �•� I7Cres
CA
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D -I
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use rn
1 (New building Residential Nonresidential
2 I I Addition(If residential, enter number 12I I One family 18 I I Amusement, recreational
of new housing units added, if any,
IX. SITE OR PLOT PLAN - For Applicant Use in Part D. 13) 13 I I Two or more family - Enter 19 Church, other religious
PPnumber of units- - - - --0. 20 I I Industrial
+ wwaarmarw.rrw:»M:�•MO wsa.m.sw» wuaNNr rarw■uuu wan= 14 3 I Alteration (See 2 above) Transient hotel, motel,MM.■aMasu.■lMr.•u. M.rM r.Mr M"wwM•M.aw»"!uw I I 21 [ I Parking garage
.•sw•::::::a..ww.•a!a MMOT•_■rr MU.M..MNuuu.Ns••NO 4 Repair, replacement
• wMO..mormea u..MMauawwwar�_OM! !•.M•MlMM"■u■■w.■M I P P or dormitory - Enter number
wMaMwwau.rMMOuw M.Nsr.■a!! M••wwwaa.r.wuoawUN*
swan.»u.• MOS•wONrw.•MM•aww w MONO Or•alww•M•uu..wu« ofunits - -� 22 Service station, repair garage
Mw.r•N_•MOu'.aM•�•urs•w swum M"MOMw•MuuurMaa« 5 Wrecking (If multifamily residential,
•rrw..•..■Mas.saMOM•'M WOO MSS. MrrrwMOMNau.•a.MIMNO
+ wr•w•lwra•■.s— --u.s arm M» w•■MwwNOtaM■■■■■.■M•N! enter number of units in building in 15 I i Garage 23 Hospital, institutional
■ ww•wM.as■•IMaa.••uw M Mw wu»w.•M.■u"w!u»
+"MrtMrNOa MM•ss.•r•'ass.w•«N••wu.M SON. Mus.Mw•rar••sa•O•NO•ES Part D. 13)
I .a•w•RAra a MM•aMMa.s._-a•O s s. MONO M.s.M..Mna"asulu. P 24 I I Office, bank, professional
+amOOOOOrss■«rwlfu» •a M.waww«•r••rrww«wr•M MOON Mu«MwrrMaw■w'w.s 16 Carport
+ Mw•!■rsr■saas�r■•.a.MO SOON w! lt5M.w«swuo■s.Mu.w 6 Moving (relocation)
i ww.aMO•raraautMMOws raw a■» r■sMM.Ms•ua•uM.•MO 25 Public utility rwaMU MMUM.•.•.aN ■:rr'oM MOOS OS".M..M..■u.•w'SMO 17 I I Other - SpeciJy
• uuu.u••a".u: wryr*M••rasamm tiNOM"M sem ..uwwwa moOOOO•a•w.ar. 7 I 1 Foundation only I sws•a•:su.sa••• M ■a.Mr::::::++Mwww M USU. MOu•aarjaOM•Nuua•MOaaaa 26 I School, library, other educational
wM.w•rM ••a•MaaM••Maaw !» w.•! MsaNaa■•aw.awsar
+ a•.■w a w■rs-M.•wassM�•OM•aw• rr w! MO •MwuNarw
+ : a.. • • MWNa.t•M'.•a•wn�w•ra.WO■aM MOOS w:•«wwwM"•rrs•wuw
irr■rsa wwusauUS }MOMrSOMOMM■'■.•MUMwr■SM M MOOR ti.arr•■OSa.NO.N"."aaw..•. B. OWNERSHIP 27 I I Stores, mercantile
N: ::• _" as .s.our...al sso. 55woar i ■NOM wi:i li���OOOOOOrsawwisawi 28 / Tanks, Towers I rR : «Yaw.rMOwrraas - 50w M MOON wa•»�w.ra.rrw■•••»•'r
Y •M.•■awlrwar.s'�a..ws■. w mum w'sMO•MOrMss•aarr•.s■••w 8ix Private (individual, corporation, to
M••••M•■r•saa.".M•rawr.M Mw M..NOM.•wrr•.•s•M•rw
Ill ■" ' MMi 's■.�M.•.a.r.aM !r waawa_a.M•aUU■awa.MINNOW
• NMr••.a ss�..wu■MO.a•.rrs.aw MOM MUMO.ra.M■. aw•sM nonprofit institution, etc.) 29 �.� Other - SpeciJy C/ �//i
+ wr.rM■wa.!• ___a■arsaaw
see.see. r•awwwwr•w"aw.■NSEr!
S r••IIM■rw»..O•■a.MOw--u.u.w NOM MOrs.a».Nswssa■s••M•s.
I = S�w■�rs.a.+MOr•.rwua! OWNS r.•wwwarOSuuuawuw 9 I I Public (Federal, State, or
+ ■ •M • s.■MO•.w..arwr•M MONO ra■.MMarla"r.MO•wMONS
aSE a MO•MIMMO.•rwa.w SWIM M.s.MIMN•r•u•a.•rwuu. local government)
rrp suu.MsarsaOOOuur rwwaa■rMaausw - _u,u.» MOw r.awwla...wwuMO.w.aw
rrrw•MO.WO" • u•u.".WON»OOONwsa.rw..w.MWO.MO•WOO•...Oa.M■O••w••M MEOW M■•»MM•MasuM■SEN'M
MM.Mrw.a...M.•M'awasM »MO w'■MOaw■aaM•.a•.eONOOSE. C. COST (Omit cents)
r .21: : MMO•aM■raysu •.uM.uM MOW wuMM. M• res wu«uM Nonresidential - Describe in detail proposed use of buildings, e.g., food
r a s.. .s.■sMN■aM•s«••MO NOON wa•wwM.• .arS wr.SNO*.
■u : .s:••t:w• ::`a:::.M.. awrrws •ws::a■wa•sa•:.S:::::s::M t I'\ processing plant, machine shop, laundry building at hospital, elementary
t : _ : • M•�:rr..Ma•.ra�rrWOa••wuw MOM M"NOM«w.urru•wuw P � �/�( $ 4V In'� school, secondaryschool, college, parochial school, parkinggarage For,
I ■••M••w•wwr.MO■••.a MOM w"wwMONMsruu• us. 10. Cost of im rovement,,,,,,,,,1 'V a7� 9 9 9
:NOON •arrw•au--.MN.Mwuaw wo M"wwraM■uuu■MOO■•a t building, office building at industrial plant.
t »N MMsa•s••»... _..MUM MONO IMUMOMwr.O•••O..UN.O.• 1 department store, rental office
MOOS ■ Mwras.RAalr•.'aaMO.M.•MO..w MOON RAa.wMw•M•ra.»•w■aMO
�Mr.•a Mr.«••uaru= wwr•..N.MSOS uruM MOS M.•«wMOMMausu■..•rw To be installed but not included If use of existing building is being changed, enter proposed use.
I ISSSSawM•r :rw■SOSa ::S�::awi:S.M•. SOWN MSSWNSO:SOM4.:SSSSSSw■IM in the above cost
1MOr• • a .s.I-_ O•■.a�M■aM.aaw MONO wO.MMr■•r..I- SUMMON.
utiMa:•:■ : : wwr w.M«■ arrM«wUM MOOS r aMswwrNM.MOON! a. Electrical / //n�
IMNiSn'•'* • MRA.wMMsa.MwM..r'w•■M COO w:N_MM..NO C. A. r .e c 6-6,-t.C 1 "Zvi !/Q
r::rrrSNr'1■wwwu»aw»ul' MONrMM.■r»wwM'.'ar'•rw MOWN w•• Mww..
wruMa N • M.wa.sMawwra•w•wu.ww MOM w... M.MOaa.
r M..•MMN•»r•rIMNNr.\wwa MOS r•rrwwaalM
arH. :�M 'rwrruaMONO• .MWO ■•.MMMr•wuM MN MOwMO■r�wsrwa o.w b. Plumbing / l� r t `! i '
......w=O:.r. : : a r{MOw:ww..O•SIO N1sUwu.■■ OWN. Muw.MMOrIM■w SOWS. /x'
iS::SMO.ui.:•arurw.uu"aw"::SS Mw•■Mwwu••M•Ma•uwuM. MOM rNlw•rwM•O■ ■wwuw
•M w._- ...alMwN.Ouw«M MOM M5•4SENMaM■
• • .................... Mw MaNMOMSE....•• a"■Y.a!
1 a' •' ' : flrtaMO. . a.aw•aw.u.0 MONO MOMMM•ww ua. ...a c. Heating,
a ::::.:S�S ,..••••.Mw•O■N�rM•■M•■w RAMS w.swMMONM.. .aa.M•w air conditioning
I•:::::::::::: r MM' aa•r•trM•a w•OM MOOS w.N«MMa••••ra ".5MOON
S MOWN a.w..._55I .wrIMwSluSW NOUN 1■rawwMONO _r•MO•u ua•wsrr
it:::::OS:::::M:::aa::::::::::: :.... «rwaw•a OSSOMMON
: �M M• RAOS::=��::awi::Ms M.RAis M:iWNaMisMw�i' w OMINNIONS �•Mu� d. Other (elevator, etc.). I 0.00 / �� '
t u"rssaa=.wa�t'MsaS : 1 MOw M•Marr..�r.'�•.saa MOa■w MMO�••UwM.• .. w»waaNO
ta•r•a5•a■ ■ a»■ .w■• MUSE .••la•wwr■•Maa•�ww.r MOO MO MMOSUN... wuINrw
t _ ari::r'::NRAi.•�:�•i�:r:iri•:i::: :.w.M.arwi M�'i. :::'�•"'::NOSi::M ss s::.Nws•M•':i•:: s::•wiri r• 11. TOTAL COST OF IMPROVEMENT $1215i , OD
':::11 '•• ri .if:::::::::::::::::: :::: WNWO= wSW.M MOw•«•O— •0SW••w MMwMOlawMNMr• MaaM�SM
OWNS. IONMUN.a=tMtMrM.•wr•M SEWN M's4MMMO•w MOw» ■w III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
t u.• a» . M aa..wsu
tt•.w..wa■,.r•.....N:::::: . :OOOra:.r": ... : �� Ms.aONM.Ou;wnaa•MO;•w"' WNaWN. �•■"•��•'�.' '��'Via. for wrecking, complete only Part J, for all others skip to IV.
i:S::SS:IN::S`:M•:SM:S'as:sa::s .T.w t: ■NMr��.:��S:M MM MMM."::"6 iss MS:WN..■w•
.•INR•• N»:" •s a •r.aM�r/w��_ `■�.■M"ww4 wMO 1.UM••wONSOOM_�»ww•u !sa ae
ISMaw'i O::: O:rMO.OSOO:::::S:iO.00SSS: :"•• m rO 1:::arM.r :w"NO Mwaar/s*•a'r•M••r «r•ws•w
`q •r r:aZi : a■ r--- ' �_Mrw• ::a.NO WOOSSAMS WOOS WOr w wrw••. MUaw..r E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
assansO:aaM:Ss«sras ■Srsm:::; WN M..O.••Y.aaaw•rw•�:■wr•RA MINI MO•.MM«.M•.• w•OM•OU _ _ -�
sas�rslaawsar aura _Uwr�/aaw.■ M.awuw 48�1 7m ber of stories
1sw w soulas u•wwr"•�aMwr• r•/ Mr OSwwwM•..■■■ Ma•M•w 3C( Masonry (wall bearing) ' 40 I Public or private company
1:::::::::::::::::::::::::::::::H MOM M-•1.•".•r•■r■aWOWO:•a■ M« ••BOSON SO SO
I : :• :a..._. . :sa • :: :MCI M«M:=�yaw::rwi magi OSNOURaa•_MOwr::: •r■::M::M 31 I Wood frame 41 I I Private (septic tank, etc.) 49. Total square feet of floor area,
li =:`{w•■.•aaraamOSsiarsourasfs a::a•:a MOM w .alla -. ••IMM_� aarw_"w roar 4.eU w•ar...rw «uw_■rw all floors, based on exterior
•S .....•S:..M. .YS::lNIII, MOM a MO
:Sa•"aa'wZ�.:ia ...-- F.F. MMO..i•M.•:■ M:.M..M
' • ■ Y ••!r wWO 1w."�i • ra •a 32 Structural steel � j dimensions 3 y8, 1/
41 .:::O•a•.MO. 8Ms:S':SO:::::•*N': : M �SS ;.wMRA"rwlM.S•wO'ON nu WORAwMMONw•■ »"wr'w
• •. MOM trON..■'•ar■••ra.rwr.ON Mw ..IMOMON■ws■ ».sw••UN
:Z •■•. 'ws a: •' • = MOM ..s r as...aa »:: NSE■MOaarwrOM rara=uWO 33 I Reinforced concrete H. TYPE OF WATER SUPPLY 50. Total land area, sq. ft.
.!a :aa:aMN.:.a�q: WN::M4MOrN« Mr. a•w '/p �/
ZsI�::::::::::::::5 s: _ = MOOSa.•MOO . rawssE.w ::l+ OSww•OSwraww ONO. MSONSONOMMOMS LauSO"s 34 I Other - Specify 42 Public or private company —
�y O. T _
J ff ::a":=WN* :::::::=:::::::::;••M'::5:: : madras,
'° :u_.w::M ■! MM •Mrriir.*.s.. ii:: s::rwaa 43 I I Private (well, cistern)marsi
K. NUMBER OF OFF-STREET
..1 iiOO:::imul::waa Srs"::!::::::::: SO ME OM.._ -::: ::SMOSM •-MI: ■rrrMS rM•MrS: .wis:M:aSO PARKING SPACES
1 ■uw uuwNs ■ _
a • u w aWN:C::: 3:::':::5•.�aS• S as■OS■MMM:S:: . :''w Mw'MrwiaMiMOMMES r:: WN::■w•:::i
1 1lrr :. .:_'.+ {/::ars::: : •. a..ras = . ..=IWNl wM.r«• s --::: ��r�. aM _mop ••wM�OSa••.s sa saiwi:awi F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed
: N •O alrwrf•"wwMN�:i ::::5::■:: ::`: , r/ *MONO Mra«.MwsSWa••N/a:5M ..MOM MM»•.a4■rNO.r MOr•»"w
PHISai :M • a::::l:61':Ii: O:S:.'w a••Mmowi �: ar_ •ea.•ia. NOSE M w « w OS••»■•w
• ■•ir sas :s::s:s • : �: u•w•r: :.r" MaM�lI •S■-i".•w ssa Z ."« MsM�PM.. Ms:.4:.MOr 35 I 1 Gas Will there be central air 52. Outdoors
i rS • is ":: : :a::::s:.::s:Su="=«•S iva= ::Iti'iM as ...: ::M NO SOUNww.RAr.■ wuruOS
S:II• : ':::w• • ra ra SEO rr MOM« ■ •w•• MOO wMO«MSE•M» MOa.Ma.! conditioning?
:I::: sa : » « " •.u■NO• arWN �SO++�=w:w M .NOi::«��� 36 I OilL. RESIDENTIAL BUILDINGS ONLY
':::M•: :::::i: : • wL•"aL :::::: x'•::WO■::err •"s ::WNW" merre_wM:.m.::Mi '
i • +� NO «ww.Mr• M"ruw
• ..■:s�2s:...: • Java. a ._:: : s us a isa :: I" :: ••rawo 37 Electricity44 Yes 45 No 53. Number of bedrooms
1111
• is::::>Isuis:3 : iii . r• its«. : = gad =s l i _i �irigar�nlI'll .Usmll:s:4i
: : :: ::•:r: : i:=:w:a•=M::::::a..■ •ws:::r:.rRA Mom.•" ■'HMO I= iim..='w=Ow.ar 38 I Coal
• Sss:: S:�:�: : :::s :O WO ■■ O �l� -M.MM.Sg�w.r.if :•OM - S S�5M.ririiMM.MSW:..:=: r 1:
_ :::::::::::::1::::::RA! :::::: ::'Lr:I::a�i::l '•!M's•''!raaMOSM•�OOOO■•■a■:::::� * _�:WNawl�ssiWNw"'ar•WN:WNiiMHM:' 39 I I Other - SpeciJy Will there be an elevators Full
54. Number of
46 � Yes 47 I 1 No bathrooms
Partial
BOCA FORM APEBP - 669 CI969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
I. -As- > E4Ja
IV. IDENTIFICATION - To be completed by all applicants
Name Mailing address - ,\'umber, street, city, and State hP code Tel. No. •
I / NOTES and Data
r04im e4�4( 64.✓1S/Ow /8( /`lpiq dS S8 s'-86`/ - (For department use)
Owner or O/O�O
Lessee ci �r Qr»p7on ,lnL /✓oi-ffirof 741// Af aSS .
,Fo 1 / 7C L / p / Builder's
2. ,T01. trr3f/r'ka. lnt'. J / eit�ieslia,'i// /e of License No.
•
Contractor
_ A��ir�ar yo o., /Ya if 58 y- 88C 9
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 `ft- Address Application date z o
lailg.,- -....e...0e-W -11-c741""rl' 6 QC/ p 00 z
" '
i -;W
•
Za.
DO NOT WRITE BELOW THIS LINE C oin
U
V. PLAN REVIEW RECORD - For office use UJ o
Plan Review Date Plans Date Plans ) C
Plans Review Required Check Fee Started By Approved By Notes
J •
BUILDING $ CO 0
PLUMBING C a
MECHANICAL $ E
ELECTRICAL $ MI o
r =
OTHER W z
P 0 zQ
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS g : L.L. z¢
U O m°
Permit or Approval Check Date Date Number By Permit or Approval Check Number By Z
Obtained Obtained
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 C%02,
Bui lding. Use Group
Permit issued (a711'_ 43` 19 R`4
Building Fire Grading
Permit Fee $ ."9 DD Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $ . .eiiLe
TIT E