17A-142 (10) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE � � �(� �i..(i�i
FRONT YARD s C
SIDE YARD �t'rj ���' SIDE YARDc
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
,."+r."�-;.<.,a',`,a*r.y��^`a`,!,_'`,..-.--.>--.'.-,.......��,g#tt�,}r."r+^,Y gb�'+t¢m�}i i.,rn+l t r s•rt-temf��}.a+�,`».firw++P a s�r-'�g�€µt,tx_+!r;"-"..:g+��;{t-.y+a'k€".+;":...'.'g y r g t r�I-}€r�s.tr"t.-te-�.p rrwr�.,.wg.°•str.":.}.,.yd,a Tr=,F;_--.-.',-3�.��Y 7.[d r��g�+'fdt g,�z aqrr s r.c;a.€r fr k^-a�ss a++t".�.a t 4�>3 o-€a¢I t d b,v+tyI�,�-��.+g ar�P,r."<°q;*a$i p�-at-
€ld
w•r�I.P t-p...s r.e fa�a c?{,'a�.^
z p44k4r€+.__..'.. o-r
gr
4
Hill,411
_ r
y _�
n I€ g
Z�ag 1 -
S` i + g
�� t 4g
d
a»Y ig-t
j�g p t-�a.,;-,_.p.�:}--�-..a a`€#�i,+•I.`.z-�¢.-g-�g3i^ei+-m�€>^-m-4."pt.:�+,kt�'+"#��f.�¢'_'^�"*L z°�,4§,.r�*�.a°
,�"T�S g g fir y fiI't r
9.+a rr t
„r 3�Y4
.}
}�^
te
°° a t
i 4-'t'
+ 1v g 3 4 g }«l •l
7 q
f
„ r a g +iq L a .+ � . a+_
� . t,a g% ~Wi t € f
pa
; 4 .=
TV
a a r b- t a "-,4 ,
H 4+- `
b _11"'M
r €,�}§firi<t~g?i�YF t
at`
.`�..
q�
a,.
�g.
§�
._,.
g'
-
..
lip-
LIZ
r
-;.g� =r.S
t € a
# a s
BOCA FORM APEBP — 669 C1969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
1.
' L? i 2'-Z C.& —y— // —6
Owner or
� 4^U
Lessee
C rr Builder's
2. Zt L lLt L' ''Q G° 1 S'T 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.
$ignat re of applicant Address Application date
j 00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
9 Fee Started Approved
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
rova I Check Date Number Permit o Date
Permit or A umer
pp N b B Obtained y P it r Approval Chec Number B Obtained y
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 I I OTHER
VII. VALIDATION
Building �0 FOR DEPARTMENT USE ONLY
Permit number
Building -7 q Use Group
Permit issued - 19_
Building V Fire Grading
Permit Fee �� �� Live Loading
Certificate of Occupancy Occupancy Load
Ap y:
r
Drain Tile .�.�.�
t'
Plan Review Fee $ 1
TITLE
NOTES and Data — (For department use)
z�
' 0
`!It
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET � 2 APPLICATION FOR
17ANORTHAMPTON, MA. 01060 ` PLAN EXAMINATION AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. G IS f D I S T R I ZONIN
�—� � ❑� �,�/�
I• AT (LOCATION)
LOCATION / (N 0.) (STREET)
OF BETWEEN T^'T /6 1 AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
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
-4
1 ❑ New building Residential Nonresidential
2 ❑ Addition(If residential, enter number 12 One family 18 ❑ Amusement, recreational
of new bousing 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 l
l
Transient hotel, mote ,
❑ 21 ❑ Parking garage
4 Repair, replacement or dormitory — Enter number
22 Service station, repair garage
5 ❑ Wrecking (If multifamily residential, of units ------- - -- ❑
enter number of units in building in 15❑ Garage 23 ❑ Hospital, institutional
Part D, 13) 16 ❑ Carport 24❑ Office, bank, professional
6 Moving (relocation) p
❑ ❑ 25 ❑ Public utility
17 Other - Specify
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP 27❑ Stores, mercantile
8 Private (individual, corporation, 28 ❑ 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
ref ,) processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement................ l + ` 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 ..................... G't'(
c. Heating, air conditioni}ngg.��.�.�,.......
d. Other (elevator, etc.).l`° I'Y.r..
11. TOTAL COST OF IMPROVEMENT $ G L
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 I
�'y`� 48. Number of stories................
30 Masonry (wall bearing) 40 I-�Public or private company
49. Total square feet of floor area,
37 Wood frame 41 E] Private (septic tank, etc.) all floors, based on exterior
32❑ Structural steel dimensions ..................... G'Z/'
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
42 Public or private company 50. Total land area, sq. ft. ...........
34❑ Other - Specify ❑ p
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 there be central air 52. Outdoors..........
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37❑ Electricity 44 ❑ Yes 45 Na 53. Number of bedrooms.....�....
38 ❑ Coal
39❑ Other - Specify Will there be an elevator? Full...�.....
54. Number of
46 ❑ Yes 47[RN. bathrooms
Partial.......
To'
k+x3
j
ELEC
� t ,
}
♦ '•. �� ��
77 fi
IME
Jp
2
U.
All
IRe
' ' CERTiFMATS lSSt,I;1��
DATE
BU
k, s
TIFICAT
'f
DATE ! 19M, _ ;___ P£I�2N(iT ND
'lift d?�PLi4NT a �s r S< .
a `
04 63 _ RiAEt3 f'Cilfi,1'Bt'$ LiE£HSB)
BUT T ( t-) 'ST* t:� a taw L)14Gdr6i TS,",
4F,IMP '> Ra,. . it*OPOSE1r,OSE) _ . .i� ...
TCOA {ON) `
)QTR
C (NO.) (STRIS;ET)
P
e #SETWEN' AND + ry s
LOT
1% SUaDwis1QN S ! 3 (y0 `_ BlOC1 a
PT. iNip $Y fT..'Y, G B` T IN ke-f4"T Affil0�hGla fFC 13M i CO4iWOICT t)N
x a't
- TYPE 4 t USE ?iOUP "#MENT;WALL$ OR F JQNDA-r ION (TAP
0.
� 'REhAARKS: }
_ t yyg
AREA'OR
YOt ll1#E r "
(tu's?cratzuA��FE>iT) �
arrtxyfrrttrtwtim. w . ,
OWNER ' F8
E - IR?iCA3'E
ADDRESS