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IDENTIFICATION — To be completed by all applicants Name Mailing address — Nurnbrr, stmt, city, and State ZIP code Tel. No. Owner or Lessee , Builder's 2. License No. Contractor z 3. 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 Tplicant Address Applicati n ddate� 00 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Pions 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 Permit or Approval Check Obtaitned 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 II. VALIDATION Building FOR DEPARTMENT USE ONLY Permit number Building Use Group Permit issued _ _ 19 AC-N9, Building Fire Grading Permit Fee $ T� Live Loading Certificate of Occupancy $ Occupancy Load Approved by: Drain Tile Plan Review Fee T LE : CITY OF NORTHAMPTON 9} �� MASSACHUSETTS e OFFICE of the INSPECTOR of BUILDINGS '"t Page .,;4 C- Plot APPLICATION FOR ZONING PERMIT AND INSPECTOR BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O Cy ZONING I• AT (LOCATION) 10-7 /-it / © /o 0Y` lI DISTRICT LOCATION (N0.) (STREET) OF BETWEEN AND BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE N IL TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D 70 A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use M M 1 ❑ New building Residential Nonresidential 2 Addition(if residential, enter number 12 ❑ One family 18 ❑ Amusement, recreational of neu, housing units added, if any, in Part D, 13) 13 Two or more family - Enter 19 ❑ Church, other religious number of units- - - - --)1. 20 ❑J Industrial 3 ❑ Alteration (See 2 above) 14 ❑ Transient hotel, motel, 21 ❑ parking garage 4 Repair, replacement or dormitory - Enter number 5 ❑ Wrecking (11 multifamily residential, of units ------- - --� 22 ❑ Service station, repair garage enter number of units in building in 15 Garage 23 ❑ Hospital, institutional Part D, 13) 16 ❑ Car P ort 24 ❑ Office, bank, professional 6 ❑ Moving (relocation) '� Public utility 17,�-Other - Specify '`°� 25 ❑ Y 7 ❑ Foundation only 26 ❑ School, library, other educational B. OWNERSHIP +Pr ,(- ►, 27 ❑ Stores, mercantile 28 ❑ Tanks, towers 8 � Private (individual, corporation, .�.�. Specify Other - nonprofit institution, etc.) 29 ❑ p fy 9 ❑ Public (Federal, State, or local government) C. COST (Omit c its) 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, 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 a. Electrical....................... b. Plumbing ..................... t 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❑ Masonry (wall bearing) 40 ❑ Public or private company 48. Number of stories................ f 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 ❑ Other - Specify 42 ❑ Public or private company 50. Total land area, sq. ft. .......... 43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed ....................... F. P INCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 35 Gas Will there be central air 52. Outdoors........................ 3 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37 ❑ Electricity 44 ❑ Yes 45 n, No 53. Number of bedrooms.............. 38 ❑ Coal 39 Other - Specify Will there be an elevator? Full.......... 54. Number of 46 ❑ Yes 47 ❑ No bathrooms Partial.,..... .qy, b A DepartmAnt £ Building Inspections 212 Matt Stet 6 BUILDING Z° v Northampton, Na. 0 1 0 0 Oa PERMIT 25C - 179 VALIDATION DATE AuguSt 911 19 82 PERMIT NO. 366 APPLICANT Gerald R Archambault ADDRESS 171 West St.$ W. Hatfield _ (NO.) (STREET) (CONTR'S LICENSE) NUMBER OF PERMIT TO Addition ( 2 STORY living rOOm DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ZONING AT (LOCATION) 107 - 109 North DIISTR CT URC (NO.) (STREET) BETWEEN AND (CROSS STREET) {CROSS 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 (TYPE) REMARKS: 3rd- at_Iry add Linn 111 X 171 fnr living room, an existing flAt roof AREA OR PER MIT VOLUME ESTIMATED COST $ 5,361,007, FEE (CUBIC/SQUARE FEET) OWNER Robert Rnravalri t BUILDING DEP ADDRESS Audabor, BY WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT CO PINK - ASSESSORS COPY -�-... ..,,_.., _.. -- ., ,�,�. _._.--. .F.TF,-�,.+u�.-.,Yr n�--�.�c-�,..- .,.�..... _..-.> ,rr} .-.o-s.v.3"'m.- --••Ji?.: mn ... �, .� �x 9 Depsxt gent of Builditti tuspections Northmaptout ma. 01060 1a Ma v street BUILDING q ryy�y . .. PERMIT J t ".i 1/9 VALIDATION ,+ DATE IZUSt 96. 19 82 PERMIT NO. 366 APPLICANT Gerald-R, Archambault ADDRESS 171 West St-s W. Hatfield (N0.) (STREET) (CONTR•S LICENSE) a NUMBER OF �y PERMIT TO Addition (mss_) STORY iiyi" DWELLING UNITS (TYPE OF IMPROVEMENT) N0. (PROPOSED USE) ZONING` AT (LOCATION) la? "` 109 North DISTRICT URC (NO.) (STREET) - BETWEEN AND (CROSS STREET) (GROSS STREET) LOT SUBDIVISION a LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY r FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION s`. TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) jall 1♦ f IF REMARKS: rt PERMIT AREA OR for liy4na roam— an existing flat wo VOLUME ESTIMATED COST . �� FEE . Lit�(aQ (CUBIC/SQUARE FEET) OWNER tml i"C# t Anyawgi"'� BUILDI/DE db ADDRESS .; BY WHITE - FILE COPY GREEN FIEW COPY CANARY ^ APPLICANT CO PINK ASSESSORS COPY r