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NOTES and Data — (For department use)
y
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
I. .� 1, r t L Z W e.� f L rufi4: G►ep S' sl:`f -2if1
Owner or
Lessee
Builder's
2
.J d J d 2- 4 We�f� �f � Ql ` .4A License No ,N
Contractor f
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.
Sign Address Application date
Le A.
0 NOT WRITE BELOW THIS LINE
V. PILAN 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 Date Number By Permit or Approval Check Date Number B
Obtained Obtained 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 �l• //
Building I Use Group
Permit issued 19 _
Building U Cif Fire Grading
Permit Fee $ `
Live Loading
Certificate of Occupancy $
Occupancy Load
Approved
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
Page �7C Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT - Applicant to complete all items in sections: 1, 11, 111, IV, and IX. C)
f r ZONING 4/O e
AT (LOCATION)
f J 1 I L S V Nt 4 V DISTRIC.-
I•
LOCATION (NO.) (STREET)
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 X
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
m
1 New building Residential Nonresidential
2 Addition([/ 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 F-] Industrial
3 Alteration (See 2 above)
14 Transient hotel, motel, 21 [—]
Parking garage
4 Repair, replacement or dormitory - Enter number
5 Wrecking (I(multifamily residential, of units ------- - -i 22 C 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) 25 r� Public utility
17 L� Other - SpeciJy
7 Foundation only 26 School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 Private (individual, corporation, 28 Tanks, towers
nonprofit institution, etc.) 29 n 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'pTant,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 9 f 1
a. Electrical.....................
b. Plumbing .......................
c. Heating, air conditioning.......... 2 y�-
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, cotnp7e>e-onrty Part J, for all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS 2—
48. Number of stories...............
30 F] Masonry (wall bearing) 40 Public or private company
31 Wood frame 41 Private (septic tank, etc.) 49. all fl square feet floor area,
all floors, based on exterior
32 Structural steel dimensions Z, j'P-C�
33 n Reinforced concrete H. TYPE OF WATER SUPPLY
34 L J Other - Specify 42 Public or private company 50. Total land area, sq. fi. ...........
43 7j Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 u Gas Will there be central air 52. Outdoors........................
conditioning?
36 C_J Oil L. RESIDENTIAL BUILDINGS ONLY
i -- LF
37 L_ 1 Electricity 44 �1 Yes 45No 53. Number of bedrooms..............
38 Coal ( r
39 Other - Specify A,+ WTTPR Will there be an elevators Full.....!...
- _ 54. Number of
�,� bathrooms '
46 Yes 47 No Partial...
DEPT. OF BUILDING INSPECTIONS BUILDING '°
212 Main Street o<
Northampton, MA 01060 PERMIT <a
17C - 99 VALIDATION
August 9, 88 515
John P. Regish DATE ADDRESS ,1 e�St• P a��e`/� Owner
APPLICANT J
(NO.) (STREET) (CONTR'S LICENSE)
Repair/Replacement(_) STORY One Famil NUMBER of
PERMIT TO Y DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
39 Sti 1 son Ave. ZONING URB
AT (LOCATION) DISTRICT
(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: permit to install new window, and renovate kitchen and bathroom (existing)
AREA OR ESTIMATED COST $ 3,000.00 y FEEMIT` 10.00
VOLUME f
(CUBIC/SQUARE FEET)
OWNER Same as Applicant
BUILDING
ADDRESS Same as Applicant's BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK -r' ASSESSORS COPY p-I F
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