32C-163 (5) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
A
SIDE YARD / SIDE YARD
REAR YARD /
NOTES
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IX. SITE OR PLOT PLAN — For Applicant Use
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BOCA FORM APEBP - 669 C1969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
IV. IDENTIFICATION – To be completed by all applicants
Name Mailing address — Number, strut, city, and State ZIP code Tel. No.
Owner or Z /V LL' ,ll I��^ ��.� rh�4i25i ��I� 31041-
Lessee j�vj3/
Builder's
L.
License No.
Contractor J (�
3. urAj ,C' `, t L'c12c- aVAv"-cTT
Architect or
Engineer 1Z tevix-i'
�vtr�cflTf
I here certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to
make thi I(cat ion as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature of ap iban'i, Address Application date
2,'�,� Co 6 4(r �1 E 2S"
I 00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD – For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
9 Fee Started y Approved y
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 �� 7
Building Use Group
Permit issued ! x ,,- 19
ft Fire Grading
Building
Permit Fee Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TI LE
NOTES and Data — (For department use)
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 3 PLAN EXAMINATION AND
/ 63 BUILDING PERMIT
z
IMPORTANT - Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
7 ZONING (/,
• AT (LOCATION) �+ DISTRICT"
LOCATION (NO.) (STREET)
OF BETWEEN �'"'7S�N� AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
CA
II. TYPE AND COST OF BUILDING - All applicants complete Parts A - D -4
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
M
I New building Residential Nonresidential
2 Addition([/residential, enter number 12 F-1 One family 18 ❑ Amusement, recreational
of new housing units added, if any,
13 Two or more family — Enter 19 ❑ Church, other religious
in Part D, 13) 1�
number of units— — — — � EX�SittiL 20❑ Industrial
3 Alteration (See 2 above) ft{d/,y-w49
14 ❑ Transient hotel, motel, 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
❑ 22 ❑ Service station, repair garage
5 Wrecking (If multifamily residential, o units —�
enter number of units in building in 15❑ Garage 23 ❑ Hospital, institutional
Part D, 13) ❑
16 Carport 24 F7] Office, bank, professional
6 ❑ Moving (relocation)
17 ❑ Other — Speci/y 25 ❑ Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8XPrivate (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 ❑ Other — Specify
9 ❑ Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food
processing plant,10. Cost of improvement,,,,,,,,,•••••••
11 Vl: school, secondary school, building
ol college, paroch alschool hospital,
king 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
a. Electrical.....................
b. Plumbing .....................
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $ , F G
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[—] Masonry (wall bearing) 40�Public or private company 48• Number of stories........+ .....
31 Wood frame 41 ❑ Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior
32 Structural steel dimensions .....................
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 F__1 Other — Specify 42�.Public or private company 50. Total land area, sq. ft. ...........
43 ❑ Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed .......................
35 Gas Will there be central air 52. Outdoors............../ .....
conditioning?36 ❑ Oil con L. RESIDENTIAL BUILDINGS 0 Y
371KElectricity 44 ❑ Yes 455 No 53. Number of bedrooms./ ...
38 ❑ Coal
39❑ Other — Specify Will there be an elevator? Full. :77
54. Number of
46 ❑ Yes 47 No bathrooms
Partial.......
hereby certify that the proposed work is authorized by the owner of record
and I have been authorized by the owner to mdkie this application'-as his
authorized agent.
SIGNATURE W AGENT
ADDRESS
(NUMBER) (STREET)
(CITY)
APPROVED BY TITLE
DATE 19
DEPARTMENT 01? BUILDING INSPECTIONS DEPT. FILE DEPARTMENT COPY
Zo
212 MAIN Tr'REET O<
N&TKAMP•Lft, MA. 01060 BUILDING Q a
32C - 163 CODE #79 PERMIT VALIDATION
DATE March 4. 19 - 80 PERMIT NO. 117
APPLICANT C(� x!pence -_ ADDRESS
(N0.) %,Aberst (CONTR'S LICENSE)
NUMBER OF
PERMIT TO IU STORY Add 7 roeidantiAl Un3,ta DWELLING UNITS �1-
(TYPE OF IMPROVEMENT) N0. (PROPOSED USE)
ZONING
AT (LOCATION) - 14 Rand DISTRICT G8
(N0.) (ST T)
a BETWEEN No
tp (CROSS R ) (CROSS STREET)
O
LOT
m
SUBDIVISION OT BLOCK SIZE
U BUILDING IS TO BE FT. WID By
0 B FT. IN HEIGHT AND SHALL CONFORM. IN CONSTRUCTION
O
m
Z TO TYPE USE GROUP ASEMENT WALLS OR FOUNDATION
(TYPE)
O
u. REMARKS:
AREA OR ESTIMATED COST $ 38,000 FEEMIT $ 114.00
VOLUME
(CUBIC/SQUARE FEET)
l�
ePT.
OWNER B UILDINADDRESS 506 Anibers y MA- 01007 _- BY
(Affidavit on reverse side of application to'be completed by authorizf owner)