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23D-004 (7) �. DEPT. FILE COPY CITY OF NORTHAMPTON ° 212 MAIN STREET BUILDING X EL NORTHAMPTON MA. 01060 23D-4 PERMIT VALIDATION DATE December 28, is 78 PERMIT NO. 625 APPLICANT nevi c1 R TPPRP ADDRESS 15 NOncrictk St. Fln (NO.) (STREET) (CONTR'S LICENSE) PERMIT TO Alter Residence (_) STORY Residence NUMBER of DWELLING UNITS 1 (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) AT (LOCATION) 15 Nonotuck ZONING (NO.) (STREET) DISTRICT URB a BETWEEN Soi th Main AND Nonntnnk a (CROSS STREET). (CROSS STREET) m SUBDIVISION LOT BLOCK SIZE a u O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION m 0 Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) O a REMARKS: A11-.Pr rPRI(3AnnA pRr app)l natal nn AREA OR ESTIMATED COST $ 2225.00 FEE $ 10.00 VOLUME PERMIT (CUBIC/SQUARE FEET) OWNER T)avi C3 F. TAAnP. BUI I T. ADDRESS 15 No-no-hunk St. , Fl nrPno , Ma. BY (Affidavit on reverse side of application to be completed by authorized agent 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 a`s his authorized agent. SIGNATURE OF `AGENT ADDRESS (NUMBER) (STREET) (CITY) APPROVED BY TITLE DATE 19 . • CITY OF NORTHAMPTON OFFICE OF THE INSPECTOR OF BUILDINGS 3b 212 MAIN STREET ° APPLICATION FOR NORTHAMPTON, MA. 01060 PLAN EXAMINATION AND BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: I, II, Ill, IV, and IX. 0 t I• AT (LOCATION) 1 0 4—UCIC 5� DISTRICT LOCATION (NO.) (STREET) n� —r} OF BETWEEN �P�L�4� r -t Al 6Q J± AND ,�+0�`�U i V BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE N II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D -� A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m m 1 I I New building Residen ial Nonresidential 2 I I Addition(If residential, enter number 12�✓One family 18 j Amusement, recreational of new housing units added, if any, in Part D, 13) 13 I Two or more family — Enter 19 I Church, other religious number of units— — — — 20 I Industrial 3 I Alteration (See 2 above) 14 I Transient hotel, motel, 4 I I Repair, replacement or dormitory — Enter number 21 I Parking garage 5 I I Wrecking (If multifamily residential, of units — —30- 22 Service station, repair garage enter number of units in building in 15 I I Garage 23 I Hospital, institutional Part D, 13) 24 I Office, bank, professional 16I Carport 6I I Moving (relocation) 7 I Foundation only 17 I Other — Specify 25 Public utility 26 I School, library, other educational B. OWNERSHIP 27 I Stores, mercantile 8 Irivate (individual, corporation, 28 Tanks, towers nonprofit institution, etc.) 29 I Other — Specify 9 I I Public (Federal, State, or local government) C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food cye processing plant, machine shop, laundry building at hospital, elementary 10. Cost of improvement $ IPr7 school, secondary school, college, parochial school, parking garage for, department store, rental office building, office building at industrial plant. To be installed but not included If use of existing building is being changed, enter proposed use. in the above cost Z� a. Electrical b. Plumbing c. Heating, air conditioning IOC) r d. Other(elevator, etc.) 11. TOTAL COST OF IMPROVEMENT $ 5 III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L; for wrecking, complete only Part J, for all others skip to IV. E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS 30[ j Masonry (wall bearing) 40 I I Public or private company Number of stories 31 I 49. Total square feet of floor area, Wood frame 41 I I Private (septic tank, etc.) all floors, based on exterior 32 I I Structural steel dimensions 33 I I Reinforced concrete H. TYPE OF WATER SUPPLY 34 I I Other — Specify 42 I Public or private company 50. Total land area, sq. ft. 43 I I Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed 35 I I Gas Will there be central air 52. Outdoors 36 I I Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37 I Electricity 44 I I Yes 45 I I No 53. Number of bedrooms 38 I I Coal 39 I I Other— Specify Will there be an elevator? Full 54. Number of 46 I I Yes 47 I I No bathrooms Partial NOTES and Data — (For department use) IV. IDENTIFICATION — To be completed by all applicants Name Mailing address — Number, street, city, and State ZIP ZIP code Tel. No. 1. —TEZC� 15 (VOcti.roR,C f."_1Or /UCH L I S . OLOG O sBtf Owner or Lessee I ZC, Lit c� Builder's (� 2. lit" �*1 1 .�SOAd ZdC'1 �O 1� 14. 1�lZTY •L ' A S License No. S13 Contractor ya� l 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_au.thorized agent and we agree to conform to all applicable laws of this jurisdiction. t Signature of Qpplic nt Address t f Application date UCLA-3U �,c_ c_t_ /C. /tinkoX 514-, 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 6,2S- Building Use Group Permit issued _ .�2', 19 Building Fire Grading Permit Fee $ /e. Live Loading Certificate of Occupancy Occupancy Load Ap rf,J by: Drain Tile 11 Plan Review Fee TITLE