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I , I ._ _. -- - —�=_�1`.T r►�'c, Gr1,�-�1 C� �157�l�J�a_ �f,�L.�".l��t�>Y.�.,; - � . I IV. IDENTIFICATION — To be completed by all applicants ' Name Mailing address - Number, street, city, and State ZIP code Tel. No. D � 3 r o S © (.-0 owner or Lessee 5399 Builder's 61 2. G 7 (� License No. / Contractor t{ov-2- 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. Si ature of a licant Address t ( Application date 8 s (4M DO NOT WRITE BEL THIS LINE V. PLAN 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 Date D Permit or Approval Check Obtained ned Number By Permit or Approval Check Obtt t ed 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 VII. VALIDATION Building / FOR DEPARTMENT USE ONLY Permit number �O Building ��.(i1 J QO Use Group Permit issued p(` ` 19 Building G� n Fire Grading Permit Fee $ fC Live Loading Certificate of Occupancy $ Occupancy Load Approved by: Drain Tile $ '� Plan Review Fee $ � ,.�-1-ITT E • CITY OF NORTHAMPTON $. .e MASSACHUSETTS • a OFFICE of t e INSPECTOR of BUILDINGS T Page i Plot APPLICATION FOR INSPECTOR j ZONING PERMIT AND BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. 0 I• ZONING AT (LOCATION) q'f) �� .a{/c.+rc DISTRICT LOCATION (NO.) f-- �/ ytSSTREET) t�A� OF BETWEEN C.Ot(2A. 9110'_ or= KJMIr�,l � +�^"��� BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE N il. 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 F-] New building Residential Nonresidential 2 Addition(If residential, enter number 12 A One family 180 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 Cl 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 L� Office, bank, professional 6 Moving (relocation) 17 Other - SpeciJy 25 Public utility 7 Foundation only 26 School, library, other educational B. OWNERSHIP 27 Stores, mercantile 6 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 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 X] Public or private company 48. Number of stories................ 31 © Wood frame 41 n 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 C� Public or private company 50. Total land area, sq. ft. .......... 43 Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed ....................... i 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 FJ Electricity 44F] Yes 45L_'� No 53. Number of bedrooms.............. 38 D Coal 39 FL—] Other - Specify Will there be an elevators Full.......... 54. Number of 46 1 Yes 47 'D N bathrooms Partial....... X F k ` ry t law YON A fly �• ti.� City of Northampton REQUIRED INSPECTIONS • 1 . Footings+lmtfi Walls � e BUILDING DEPARTMENT `2 ' Structural Components in Place 3. Complete Building No. -286- Office of the Building Inspector Date 19`E BU11 -j''DING P RMIT Ott wote4dlo -THIS MAY CERTIFY THAT J.H,Ziatnnsla Im• Insp. on Site -- Foundations has permission toAdAticn tO Pr Insp. of Plumbing — Rough situated on 40 Hates St. Insp. of Plumbing — Finish provided that the person accepting this permit shall in every re- Insp. of Wiring — Rough spect conform to the terms of the application on file in this office, and to the provisions of the Statutes and the Ordinances relating Insp. of Wiring— Finish to the Construction, Maintenance and Inspection of Buildings in Insp. of Health (Septic Tanks) ' the City of Northampton.Any violation of any of the terms above noted is an immediate revocation of this permit. Expires six Building Insp — Rough months from date. Building Insp;. — Finish Note: A certificate of occupancy will be issued by this office upon return of this card signed by the Plumbing,Wiring and Building Smoke Detectors (Fire Dept.) Inspectors. Gas Inspection THIS CARD MUST BE DISrLAYED IN A ONSPICUO ' PLAC E PREMISES Certificate of Occupancy L'3;® �`-'`� Building,Inspector AIML i