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IDENTIFICATION — To be completed by all applicants Name Mailing address — Number, stmet, city, anal State ZIP clde Tel. No. 1. f Owner or • Lessee u i l e s ,2 '7— L �� License No. Contractor �4 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. Signaturepl�n`��Lc�ryL� / Address ApGplfica i�n ate J(��JI�nJ, D0 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plan Review Date Plans Date Plans Plans Review Required Check Fee Started By Approved BY Notes BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL $ OTHER $ VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Date ole Permit or Approval Check Obtained 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 �41 �,9, i9 A Building Fire Grading Permit Fee $ Live Loading Certificate of Occupancy $ Occupancy Load Ap ed by: � t Drain Tile $ Plan Review Fee $ l/ TITLE CITY OF NORTHAMPTON B* °� • MASSACHUSETTS j OFFICE of the INSPECTOR of BUILDINGS Page Plot APPLICATION FOR ZONING PERMIT AND INSPECTOR BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O jZONING AT (LOCATION) DISTRICTuA� LOCATION ' STREE T' 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 -a 1 New building Residential Nonresidential 2 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 22 Service station, repair garage 5� Wrecking (11 multifamily residential, of units --► � P 9 9 enter number of units in building in 15 Garage � ) 23 Hospital, institutional Part D, 13) 16 6 Moving (relocation) Carport ort 24 Office, bank, professional � 17 Other — Specify 25 E] Public utility 7 Foundation only 26 School, library, other educational B. OWNERSHIP 27 Stores, mercantile 8 Private (individual, corporation, 26 Tanks, towers nonprofit institution, etc.) 29 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 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 $ s 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 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 F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ....................... 35 Lj Gas Will there be central air 52. Outdoors........................ 36 [_—] Oil conditioning? _ L. RESIDENTIAL BUILDINGS ONLY 37 r Electricity 44 Yes 45 No {� 53. Number of bedrooms.............. 38I Coal 39 L� Other — Specify Will there be an elevator" Full.......... I� 54. Number of 46 [ a I Yes 47 No bathrooms Partial........ Department of Building Inspections 212 Main Stree&�,,, BUILDING '° Northampton, Maj, 01060 as 1Q, �l PERMIT y/ 17A - 5$ VALIDATION DATE _April 2. 19 82 PERMIT NO. 105 APPLICANT `(eral A Arcb—b-11 t ADDRESS 171 Wes t Sty _ (y�� HAt�fI el d _ (NO.) (STREE� (CONTR'S LICENSE) NUMBER OF 1 PERMIT TO (1__) STORY DWELLING UNITS ( YP IMP OVEMENT) NO. PROPOSED E1 ZONING AT (LOCATION) 197 Ar DISTRICT 11� (N0.) (STR T) 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: Demolition of one car garage - no rebuilding a& this time - foundation to remain AREA OR PERMIT VOLUME ESTIMATED COST $ 100.00 FEE (CUBIC/SQUARE FEET) S OWNER �L6b @a<k CaSbman BUILD ADDRESS 107 Bridge Rd., Northampton, Ma, 01060 — BY WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK ASSESSORS COPY