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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 p Address Application date 00 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plan Review Date Plans Date Plans Plans Review Required Check Fee Started BY Approved BY Notes BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL $ OTHER $ VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approval Check Date Number By Permit or Approval Check Date Number Obtained Obtained N b 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 �? Building Permit issued l U.� E"� 19 Use Group Building fy1 /2 Fire Grading Permit Fee Live Loading Certificate of Occupancy $ Occupancy Load Approved by: Drain Tile $ <------17 Plan Review Fee $ TITLE o - CITY OF NORTHAMPTON B. MASSACHUSETTS $ e OFFICE of the INSPECTOR of 'BUUILDINGS Rage �`� Plot APPLICATION FOR ZONING PERMIT AND INSPECTOR BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O ZONING I• AT (LOCATION) DISTRICT LOCATION (NO.) (STREET) OF BETWEEN AND- BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE V1 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 1 ❑ New building Residential Nonresidential 2 Addition(If residential, enter number 120 One family 18 Amusement, recreational of new housing units added, if any, in Part D, 13) 13 � Two or more family - Enter 19 �� Church, other religious number of units- 20 J Industrial 3 Iteration (See 2 above) 14 Transient hotel, motel, ❑ 21 �_. � Parking garage 4 L Repair, replacement or dormitory - Enter number 5 ❑ Wrecking (If multifamily residential, of units ------- - -� 22 � � Service station, repair garage enter number of units in building in 15 Garage 23 Hospital, institutional Part D, 13) 24 16 � Carport Office, bank, professional -� 6 Moving (relocation) Public utility 25 17�] Other - Specify �� 7 n Foundation only 26 School, library, other educational B. OWN RSHIP 27 L Stores, mercantile 8 Private (individual, corporation, 28 n Tanks, towers nonprofit institution, etc.) 29 L--] Other - Specify 9 n Public (Federal, State, or local government) C. COST (Omit cents) Nonresidential - Describe in detail proposed use of buildings, e.g., food processing plant, machine shop, laundry building at hospital, elementary 10. Cost of improvement,,,•••.......... $ 016b,10 school, secondary school, college, parochial school, parking garage for department store, rental office building, office building at industrial plant. Fo be installed but not included If use of existing building is being changed, enter proposed use. in the above cost a. Electrical.......... ........... r b. Plumbing ..................... _ `7 c. Heating, air conditioning......... d. Other (elevator, etc.)............. _ 11. TOTAL COST OF IMPROVEMENT 1i 6CO. 00 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 48. Number of stories................ 30 C� asonry (wall bearing) 4J �� Public or private company 41 r Private (septic tank, etc.) 49• Total square feet of floor area, 31 Wood frame I_ p all floors, based on exterior 32 n Structural steel dimensions ..................... 33E] Reinforced concrete H. TYPE OF WATER SUPPLY Other 42 �� Public or private company 50. Total land area, sq. ft. .......... 34 - Speci/y 43 Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed ....................... F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 35 E Gas Will there be central air 52. Outdoors........................ 36E_1 Oil conditioning? �__ . _ L. RESIDENTIAL BUILDINGS ONLY 37 L_ Electricity 44 Yes 45 /No 53. Number of bedrooms............. 38 Coal - 39 Other - Specify Will there be an elevator° Full.......... - 54. fJumber of -� bathrooms 461- Yes 47 No Partial........ "- � t r 11,11 r ./' r ' — n7 �. " 4p a 3 i x �' � � :__�,� 11 M'. i ",;.,:,�k,," �,', - � r x 3 i ✓, a 1 S$A"Y^" 5 3 �`�. ?s�' s. � ,r�' '"`�,`+Ts' $;.,a ` mad; v 'z 00103 _0 P 1 �m aka. �,' „ �'z r 3r a,r � z'IF'r x ' :? ,fin ., -r ° fir '.-# ,y^''` # > `' ^- ` 1 i. a^:, �^ fie' ?, �,- .t+� 'T '« 'v etc " 3 gae - xr+ F ?v"F 11.c �s.�rY. o .z` ��° & -,.- 'iz ,� a�-e - "r".1 �' n �.. "n "G _ '*, "'T €` s:fs' # Y 'e .,.*.'_,`�,�° .�' � � *� n 11 11 "K M�' "' �' '*«, _ . ,R+.x.+ .E` .� .., .<:- ',,: „tau. h 3 s,�"a u a,:* :��A I .`e`�., c�.'I I --...s. �- P..... 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