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Architec 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 00 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Required Check Plan Review Date Plans By Plans B Notes Fee Started y Approved y 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 Building ' , 1 ' C Use Group Permit issued 19 Building Fire Grading Permit Fee $ Live Loading Certificate of Occupancy $ Occupancy Load Approved by: Drain Tile $ Plan Review Fee $ TITLE CITY OF NORTHAMPTON MASSACHUSETTS e OFFICE of the INSPECTOR of BUILDINGS Page Plot—� APPLICATION FOR a,�T ZONING PERMIT AND INSPECTOR BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. 0 ,.+ ZONING E/— DISTRICT I• AT (LOCATION) LOCATION ("O.) (STRE T) / 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 ;0 M A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m 1 New building Residential Nonresidential 2 Addition(If residential, enter number 12 One family 18 Amusement, recreational of new bousing units added, if any, 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 L Repair, replacement or dormitory — Fnter number 5 Wrecking (If 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 Carport 17�� Other — Specify 24 Office, bank, professional L� 6 Moving (relocation) 25 L Public utility _ 7 Foundation only 26 School, library, other educational C_ B. OWNER I 27 Stores, mercantile 8 Private (individual, corporation, 28 L Tanks, towers nonprofit institution, etc.) 29 Other Specify 9E] 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 school, secondary school, college, parochial school, parking garage for, 10. Cost of improvement•,•,,,,,•••.... department store, rental office building, office building of 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 $ �C 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 48. Number of stories................ 30 D Masonry (wall bearing) 40 Public or private company 31 Wood frame 41 L 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 WATER SUPPLY 34 L Other — Specify 42 � Public or private company 50. Total land area, sq. ft. .......... 43 L Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed ....................... F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 35 G a Will there be central air 52. Outdoors........................ 36 Oil conditioning? 4-,< L. RESIDENTIAL BUILDINGS ONLY 37 C L _� Electricity 44 ] Yes 45 53. Number of bedrooms.............. 38 Coal 39 �� Other — Specify Will there be an elevator° Full.......... 54. Number of 46 Yes 47 No bathrooms �— Partial....... 'DEPT:OF BUILDING INSPECTIONS BUILDING '° j 1 212 Main Street O` Northampton, MA 01060 PERMIT <a 11C - 21 VALIDATION DATE Y 1 244 APPLICANT Joseph Sykier ADDRESS �1b 4IHiP yl,IT/IV O. (NO.) (STREET) r(a (CONTR'3 LICENSE) One Family NUMBER OF PERMIT TO Alteration (_) STORY DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) 5 Heffernan St. , Leeds ZONING 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 permit for the removal of single window and install double windov�TYPE, REMARKS: 500.00 PERMIT 10.00 AREA OR VOLUME ESTIMATED COST $ FEE (CUBIC/SQUARE FEET) Bradley & Carolyn Levay OWNER BUII ADDRESS BY WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK ^ ASSESSORS COPY pjNT P