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IDENTIFICATION — To be completed by all applicants Name Mailing address — Nurnbcr, stmt, city, and State ZIP code Tel. No. Owner or 2, Lessee &0 �+✓3- Bui Ider's 2. License No. Contractor 3. Architect or Engineer S eo FA .S I hereby certify that the proposed w64 is authorized by the owner of record and that I have been authorized by the owner to make this applicatio as his authorized agent and we agree to conform to all applicable laws of this jurisdiction. ig ature of p licant Address Application date b -� � Zy DO NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Required Check Plan Review Date P y Ions B Date Plans By Notes Fee Started Approved BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL $ OTHER $ VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approva I Check Date Number B Permit or Approval I Check Date Number B Obtained y Pp Obtained Y 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 �� Building. Use Group Permit issued 19 P2, Building Fire Grading Permit Fee $ 2�� U+ Live Loading Certificate of Occupancy $ Occupancy Load Approved by: Drain Tile $ Plan Review Fee $ r` T L E CITY OF NORTHAMPTON 9� "$ MASSACHUSETTS y OFFICE of the INSPECTOR of BUILDINGS Page Plot �,� APPLICATION FOR ZONING PERMIT AND INSPECTOR BUILDING PERMIT z IMPORTANT — Applicant to c C) complete all items in sections: I, 11, Ill, IV, and IX. K'��^✓7� GO l I I I `S I ZONING AT (LOCATION) I. b O tl DISTRIC Y� LOCATION (NO.) (STREET) OF BETWEEN AND BUILDING (CROSS STREET) CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE N II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D A A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m m 1 ❑ New building Residential Nonresidential 2 Addition(► residential, enter number f 12 F-1 One family 18 ❑ Amusement, recreational of new bousing units added, if any, in Part D, 13) 13 Two or more family — Erzter � 19 ❑ Church, other religious number of units— — — — 20 ❑ Industrial 3�.Qlteration (See 2 above) 14 E] Transient hotel, motel, 21 ❑ Parking garage 4 ❑ Repair, replacement or dormitory — Enter number 5 ❑ Wrecking (if multifamily residential, of units ——————— — -i 22 Service station, repair garage enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional Part D, 13) 16 ❑ Carport 24 ❑ Office, bank, professional 6 ❑ Moving (relocation) 17 Other — SpeciJy ,0 25 ❑ Public utility 7 ❑ Foundation only 26 ❑ School, library, other educational B. OWNERSHIP 27 ❑ Stores, mercantile 8 Private (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 r processing plant, machine shop, laundry building at hospital, elementary 10. Cost of improvement,,,,,,,,,,,,,,,, J�DO, 00 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 e� a. Electrical..................... .p b. Plumbing ..................... C c. Heating, air conditioning.......... d. Other (elevator, etc.)............. 11. TOTAL COST OF IMPROVEMENT $,S0 00.C) 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 30ttA 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, �y all floors, based on exterior (� 32 ❑ Structural steel dimensions ..................... Q 33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY 34 ❑ Other — Specify 42 F-1 Public or private company 50. Total land area, sq. ft. ........... 43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed ....................... F. PRINCIPAL TYPE OF HEATING FUEL TYPE OF MECHANICAL 35 Gas there be central air 52. Outdoors........................ 36 ❑ Oil condi ' ning? L. RESIDENTIAL BUILDINGS ONLY 37 Electricity 44 ❑ Yes 45 No 53. Number of bedrooms.............. 38 ❑ Coal 39 ❑ Other — Specify Will t re be an elevo ? Full.......... 54. Number of 46 ❑ Yes 47 bathrooms Partial........ f BUILDING zQ PERMIT a � VALIDATION (nom I3 ATE 2 19� PERMIT NO. �7� APPLICANTa/`�3"- " 17 ADDRESS Po acy 6 7r (NO.) (STREET) (CONTR'S LICENSE) �_ d -� ///�'//���y�� -- jj..��''��rr ,,,� �f NUMBER OF PERMIT TO [ 7 ► (l' ) STORY 1`2h "''- _ onl '� DWELLING UNITS _ (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ,7 ZONING AT (LOCATION) 0 DISTRICT (NO.) (STREET) BETWEEN AND (CROSS STREET) (GROSS 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 17 � . R� � '1 (TYPE) REMARKS: �`••��YL `e 1 y , f AREA gCl�J ESTIMATED COST $ FEE MIT VOLUME $- r (CUBIC/SQUARE FEET) /2 OWNER BUIL NG PT. p 5 -w. ADDRESS 20 +`'w/ BY WHITE - FILE COPY GREEN - FIELD COPY CANARY ^ APPLICANT OPY INK SSORS COPY