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F F$$ $ $ F1aee:Fi11 ssga$gi FF�eF;FFF=a::�Fs$a$:aa:::::::::: sg�'•$ as FesiF eJUNE' Jul all:Faa$Eieenut.ee'seee 8-na ' ue�aa��g $$�:Fa?$a�:ss:a:aa2:aaas:s:F::::: NOTES and Data — (For department use) O � �Rsasadtnaetta Qllf� of wort 1jamptall x DEPARTMENT OF BUILDING INSPECTIONS INSPECTOR 212 Main Street ' Municipal Building •' Northampton, Mass. 01060 v, AS A HOMEOWNER I UNDERSTAND THAT I MAY APPLY FOR AND RECEIVE A BUILDING PERMIT FOR A HOME OR ADDITION I INTEND TO LIVE IN. I ALSO UNDERSTAND THAT I AM RESPONSIBLE FOR KNOWING THE STATE BUILDING CODE AND ZONING ORDINANCE OF THE CITY OF NORTHAMPTON. BEING A HOMEOWJNER AND NOT A PROFESSIONAL CONTRACTOR IN NO WAY ABSOLVES ME OF ANY RESPONSIBILITY TO INSURE THAT ALL FACETS OF THE RULES AND REGULATIONS ARE COMPLIED WITH. IV. IDENTIFICATION — To be completed by all applicants ame Mailing ess — Num er, stmt, city, and State ZIP code Tel. No. Owner or Lessee Builder's 2. License No. Contractor 3. Architect or Engineer I hereby certify that the proposed work is authorized by the owner of record and that I ve been authorized by the owner to ake m is application as autho d agent nd we ogre t c rm to appfi ab ws this jurisdiction. na a li a t Add es J is lion at c 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 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 Building _ Use Group Permit issued �� ' 3 �� 19 Building Fire Grading rQ J Permit Fee $ Live Loading Certificate of Occupancy $ Occupancy Load Approved by: Drain Tile $ ~ Plan Review Fee $ "�` n ,T l-r CITY OF NORTHAMPTON �• +� MASSACHUSETTS $ f OFFICE of -the INSPECTOR of BUILDINGS �T Page Plot APPLICATION FOR INSPECTOR ZONING PERMIT AND BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O �[( ZONING I• AT (LOCATION) h U �JZ DISTRICT LOCATION (RO•) // '' (5 TR EET) 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. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m M 1 XNew building Re ' ential Nonresidential 2 ❑ Addition residential, enter number 12 One family 18 ❑ Amusement, recreational of new housing units added, if any, 13 wo or more family — Enter 19 ❑� Church, other religious in Part D, 13) number of uni t s— — — — —> 3 ❑ Alteration (See 2 above) 20 ❑ Industrial 14 ❑ Transient hotel, motel, 21 Parking garage 4 ❑ Repair, replacement or dormitory — Fnter number 5 ❑ Wrecking (It multifamily residential, of units ——————— — -- 22 L 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) 7 ❑ Foundation only 17 L] Other — Specify � 25 ❑ Public utility 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 processing plant, machine shop, laundry building at hospital, elementary 10. Cost of improvement,,,,,,,,,,,,,,,, school, secondar y 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 a. Electrical.................... b. Plumbing ...................... c. Heating, air conditioning.......... d. Other (elevator, etc.)............. 11. TOTAL COST OF IMPROVEMENT $ 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 40 Public or private company 48. Number of stories............. 31 ❑Wood frame osonry (wall bearing) 41 rivate (septic tank, etc.) 49• Total square feet of floor area t all floors, based on exterior 32 ❑ Structural steel dimensions .................... 33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY 34 ❑ Other — Specify 42 ublic or private company 50. Total land area, sq. ft. ........... 43 t (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES F. PRINCIPAL TYPE OF HEATING FUEL 1. TYPE OF MECHANICAL 51. Enclosed ....................... 35 ❑ GasWill there be central air 52. Outdoors........................ 36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37 j Electricity 44 Yes 45 4 j No — . 53. Number of bedrooms.............. 38 ❑ Coal 39 Other — Specify Will there be an elevators Full.......... 54. Number of 46 �1 Yes 47 !o bathrooms portial....... z '� d o � w cn 75. O 0 0 4.4 c3 C � p O ° 00 a '� k F �•y r�-I �i, �+= �p p ate.. � •� A y .G 0 O •ro .a) a• � � o � •^ � d C) cn N co co � 4-) ►� L. o a c c (31 n z p O .0 LA G� O �«. • .p b C O O V w v C C , +• V POOR ��•Of z