25C-095 (31) Location.....................................................................
f
PermitNo. .................................................................
Application for other than a Dwelling
PermitGranted........................................... 19.........
To ..............................................................................
-�► 140TE:IN ORDER THAT THIS APPLICATION MAY BE ACCEPTED,THE DATA CALLED FOR BELOW MUST BE SO SET FORTH THAT
WE CAN DETERMINE FROM THE APPLICATION AND THE ACCOMPANYING PLANS WHAT THE EXISTING CONDITIONS ARE AND
WHAT THE FUTURE CONDITIONS WILL BE.
Plans,in duplicate,must be filed with this application before a permit will be granted,one of which,upon issuance ,
of the permit shall be kept at the site during the progress of the work.
New...............❑
�/ cl/ Addition........El No... l)....—D, Zone.................... Type..................., Map..................... Parcel..................... Alterations ....❑
Repair............❑
CITY OF NORTHAMPTON Demolition....❑
MASSACHUSETTS
Application for other than a Dwelling Permit
(To be filled out in ink OR on a typewriter) `)j
To the Building Inspector: Date......4��. ..�1: ............. 19/••`x•
Application for a permit is hereby made ordin �o the ff ll v ng:~
1. Location, Street and o.... .... . ..... .. .. `..1............: ................................................................................
2. Nearest cross street �.C.4!:. ....... v.�................ ..................................../..�..... ...... �j°°t No..�...l.............
3. Owner's name....../..l.C7�rt t ... � c�. ....... Address ..7I...4,�U .Ul �.U.j.%:.i.t�l�1�1! ����
4. Architect's name..........................................`.............................. Address ........................................ I
5. Builder's name i Q; ` ? �. .............. Address ..r '...`. .1 : ..................
j� ,�iVi r�l/�
6. Use of building, Present..�i J...l...4.4:f::.............4JProposed .........................................................................
7. Building fronts on how many Streets?..........01L!,,E...........................................................................................
8. Is building in fire district?............................ ...................................f......................................... ..*
t� t 1. Length in ft..........Q.......... Height in ft.....
9. Size of building,Width in ft. ......... .. .........` .............
10. Distance of building from Street Line...,1t5—..., left lot line..........., right lot line..........., rear lot line...........
11. Type of construction(check one): 1—A.......... 1—B .......... 1—C .......... II.......... III.......... IV.......... V ..........
Stories B 1 2 3 4 5 6 7 Roof
Story heights in ft.
Thickn's of walls in ins.
Material of walls
Material of floor/roof
Design live load
Design dead load
Occupancy or Use
No.of persons/families
No.of stairs
12. Soil under footing is.......0..�: .... ..... .................................................................. ....................................
13. Depth of footing below grade.................../............ ft. Will piles be used?........../..�r)................
14. Area of entire building(Print plus new) ........................................................... sq.ft.
15. Type of roof—flat.....j..11../........, pitched........... ..I..'...) Material of roof covering. �............
16. No.of elevators......t....... Method of heating�-0.. System ................................. Fuel ...... ...............
17. Are live loads noted on drawings? ............... Are all other structural conditions noted on drawings ...................
18. Building(will be)(is)equipped with sprinklers? ��..��......... With sprinkler alarm?.......
19. Is building to be used as a factory,workshop or mercantile or other establishment employing 10 or more persons?
...................................................................................................................................................................................
20. Is building to be used as an office building,dormitory,hotel,family hotel,apartment or boarding house,lodging
house or tenement house having 8 or more rooWs.above the second story? ...........................................................
21. How many exits(per floor)to street? ............6......................................................................................................
22. Is building a"Place of assembly"as defined by the General Laws? .......................................................................
23. Will building conform to the General Laws? ............. Building and Zoning Ordinances? .........................
24. If a garage,distance from nearest building? .......7..
��../�.t........... .
...
25. If an addition,alteration or demolition,when was building erected?......................................................................
26. Estimated costs:
The undersigned certifies that the above statements are true to the best
General$.........�`�..`. ...�........ o his/her knowyled e and belief.
Plumbing......................................... ti�1...4.....
.... . . ...
. .. . ...... .......... ... ...... . ................ ............
GasPiping....................................... Signature of owner,architect or ngineer
Sprinklers........................................ WRITTEN DISCRIPTION OF WORK TO BE DONE
Heating (Use blank half of reverse side,if necessary) 1
............................................ �' ) ' .Electric .
� .... .. .
Other................. ..... .. .
Total$...............A�.t. A7.�.... ...................................................................................
HINT SH P
City of Northampton Q
RE UIRED INSPECTIONS
1 . Footings and Walls
1n
BUILDING DEPARTMENT 2 . Structural Components in
Place
3 . Complete Building
No. 485 Office of the Building Inspector
Date August .1, 19_2Q_
BUI DING P RMIT
THIS MAY CERTIFY THAT JAMES DAWSON Insp. on Site — Foundations
has permission to INSTALL NEW DOOR IN EXISTING WINDOW OPENING Insp. of Plumbing — Rough
situated on 211 NORTH STREET Insp. of Plumbing — Finish
provided that the person accepting this permit shall in every re- Insp. of Wiring — Rough
spect conform to the terms of the application on file in this office,
and to the provisions of the Statutes and the Ordinances relating Insp. of Wiring — Finish
to the Construction, Maintenance and Inspection of Buildings in Insp. of Health (Septic Tanks)
the City of Northampton. Any violation of any of the terms above
noted is an immediate revocation of this permit. Expires six Building Insp. — Rough
months from date. Building Insp. - Finish
Note: A certificate of occupancy will be issued by this office upon
return of this card signed by the Plumbing, Wiring and Building Smoke Detectors (Fire Dept.)
Inspectors. Gas Inspection
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS,PL CE CIN T E PREMISES
Certificate of Occupancy
Building Ins r
P INP