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IDENTIFICATION — To be completed by all applicants Name Mailing address — Number, street, city, and State ZIP code T`eI. No. Owner or rao Lessee Bui Ider's 2. je License No. Contractor 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 applicant Address Application date D0 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Required Check Plan Review Date Plans B Date Plans By Notes Fee Started y Approved BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL $ OTHER Is V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Date Date Permit or Approval Check Obtai ed 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 Buildin g - Fire Grading �Gf Permit Fee vo Live Loading Certificate of Occupancy Occupancy Load pproved y: Drain Tile $ Plan Review Fee $ TITLE i CITY OF NORTHAMPTON MASSACHUSETTS OFFICE of the INSPECTOR of BUILDINGS Page 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 +j 1 ZONING I• AT (LOCATION) s• / , DISTRICT LOCATION (NO.) (STREET) OF BETWEEN AND BUILDING CROSS STREET) CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE H 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 ❑ New building Residential Nonresidential 2X Addition(If residential, enter number 12 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 ❑ Industrial 3 ❑ Alteration (See 2 above) 14 ❑ 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 — Specify 25 ❑ Public utility 7 ❑ Foundation only 26 ❑ School, library, other educational B. OWNERSHIP 27 ❑ Stores, mercantile 8 ❑ Private (individual, corporation, Q 28 ❑ Tanks, towers nonprofit institution, etc.) �/ �t.t�n1A+�0�9 L] Other — Sped/y 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, 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 .................... 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.............. 31 Wood frame 41T7 Private (septic tank, etc.) 49. Total square feet of floor area, all floors, based on exterior 3271 Structural steel dimensions ..................... 33 l � Reinforced concrete H. TYPE OF WATER SUPPLY 34 ❑ Other — Specify 42X 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 I. TYPE OF MECHANICAL 35 Gas Will t re be central air 52. Outdoors....... 36 Oil conditio ' g? L. RESIDENTIAL BUILDINGS ONLY 37 j Electricity 44 Yes 45 •, No 53. Number of bedrooms.............. 38 ❑ Coal 39 n Other — Specify Will there a an elev tort Full.......... 54. Number of 46 Yes 47 ❑ No bathrooms Partial....... INSPECTION RECORD DATE NOTE PROGRESS - CRITICISMS AND REMARKS INSPECTOR FIELD COPY DBPAMMENT 4E' BUILDING rNSPBCTIONS 212 NM STREET BUILDING WMUN M, NA. 01060 PERMIT 12C - 66 DATE AMst 29, 1980 PERMIT NO. 454 APPLICANT Paul Straece ADDRESS 21 Harald Street (N 0.) (STREET) (CONTR'S LICENSE) NUMBER OF PERMIT TO Cl�" & stove ( ) STORY For waod-t112T'[l tiQ $toyo DWELLING UNITS 4 (TYPE OF IMPROVEMENT) NO. (PROPOSED USE ZONING AT (LOCATION) 21 Harold DISTRICT URA (NO.) (STREET) rn BETWEEN AND 10 (CROSS STREET) (CROSS STREET) a a LOT m SUBDIVISION LOT BLOCK SIZE a U O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION m O Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION � (TYPE) O LL REMARKS: Exterior mason&= Chimney, Install ynod-hurniug stove Ve'lmout Castings - Resolute Label/ q _ %_ AREA OR MIT VOLUME ESTIMATED COST $__�� LZF"E' 10 00(CUBIC/SQUARE FEET) OWNER Paul Stracc© ADDRESS 21 Harald Street, Northupton, Ma. 01U60 I hereby certify that the ptopose4 work is authorized by the owner•of reeorc and I have been authorized by the owner to make this application as his authorized agent. SIGNATURE OF AGENT ADDRESS (NUMBER) (STREET) (Cl TY) APPROVED BY TITLE DATE 19 'a DEPT. FILE COPY DEPARTMENT OF BUILDING INSPECTIONS BUILDING 212 MAIN STREET BUILDING as NORTHAMPTON,, MA. 01060 PERMIT VALIDATION 12C • 66 DATE August 29, 19 80 PERMIT NO. 454 APPLICANT Paul Stracco ADDRESS 21 Harn1 d Strpet (NO.) (STREET) (CONTR'S LICENSE) PERMIT TO Chimney & stAVe (�_) STORY FAr [�• ttrn no a NUMBER OF -T VoCk b i-p to1�a DWELLING UNITS 1 (TYPE OFD I MPROVEMENT) NO. (PROPOSED USE AT (LOCATION) 21 Harold ZONING DISTRICT-1TRA (NO.) (STREET) a� BETWEEN A °D (CROSS STREET) (CROSS STREET) a Q. LOT m SUBDIVISION LOT BLOCK SIZE u BUILDING IS TO BE FT. WIDE BY FT. L G FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION O m O Z TO TYPE USE GROUP BAS ME WALLS OR FOUNDATION f 0: (TYPE) o REMARKS: Exterior masonry chimney_ install wood-burning stave Vermont Castings - Resolute UL Label AREA OR PERMIT VOLUME ESTIMATED COST $ FEE ' (CUBIC/SQUARE FEET) OWNER path StracCA ADDRESS 21 Harold Street. Northampton- Ma- 01060 B (Affidavit on reverse side of application to be completed by authorized agen of owner)