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IDENTIFICATION – To be completed by all applicants Name Mailing address — Number, street, city, and State ZIP code Tel. No. 1. Owner or Lessee 741 Builder's 2. 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. Si not 4 o a Flit t Address Application date oe /< -ice 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 Fee Started Approved BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL $ OTHER $ VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or A rovaI Check Date Number B Permit or Approval Check Date Number B PP Obtained y Pp 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 Use Group Permit issued -�-� � 1 19 _ Building $ � `�` a � Fire Grading Permit Fee l//l �UNX]CT�].+V Live Loading Certificate of Occupancy $ Occupancy Load $ APpr�Yed by 7 Drain Tile 7-7 Plan Review Fee $ ' ' F /� TITLE CITY OF NORTHAMPTON �. ' MASSACHUSETTS $ OFFICE of the INSPECTOR of BUILDINGS � ,Ut Page 1`�- Plot -� C' APPLICATION FOR ZONING PERMIT AND INSPECTOR BUILDING PERMIT z IMPORTANT — App/l/ica�n�t7 to complete all items in sections: 1, 11, III, IV, and IX. C) ZONING • AT (LOCATION) f�D /`•^ /y f DISTRICT LOCATION t IN 0.) (STREET) OF BETWEEN Rte 1 "" C- AND I STReEr) BUILDING (`ROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE N II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D A A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m m 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 3 Alteration (.See 2 above) number of units— — — — —� 20 r J Industrial 14 , Transient hotel, motel, I_] Parking garage �__ 4 Repair, replacement or dormitory — tinter number 21 urrit.s ——————— — --� 22 Imo. ) Service station, repair garage o 5 � Wrecking (l/multifamily residential, / enter nuneber of units in building in 15 Garage 23 Hospital, institutional Part D, 13) 16 Car ort 24 Office, bank, professional 6 �] Moving (relocation) �_ p —� 17 [_ '1 Other — Speci/y, _ 25 ) Public utility 7 �� Foundation only 26 r School, library, other educational L B. OWNERSHIP — 271 ] Stores, mercantile 8 Private (individual, corporation, 28 �� Tanks, towers nonprofit institution, etc.) 29 j Other — Specify 9 L� 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,••••••,•,.•.,.• 0,60 school, secondary school, college, parochial school, parking garage for department store, rental office building, office building at industrial plant. 7'o 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 [__11 Public or P rivate company 48. Number of stories............... 31 Wood frame 41 I_.� 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 n Other — SPecz6 42 Public or private company 50. Total land area, sq. ft. ........... 43 j Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed ....................... F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 35 L] Gas Will there be central air 52. Outdoors........................ 36 LF—] Oil conditloning'� L. RESIDENTIAL BUILDINGS ONLY 37 [_'j Electricity 44x, Yes 45 '_ No 53. Number of bedrooms.............. 38 l Coal 39 [—] Other — Spr'cify will there be an elevotor Full.......... _ 54. Number of 46 [ Yes 47 ' No bathrooms Partial........ Elk City of Northampton REQUIRED INSPECTIONS $ f 1 . Footings and Walls . - BUILDING DEPARTMENT 2 • Structural Components in Place 3 . Complete Building No. 671 Office of the Building Inspector Date September 18. 19 89 BUI DING P RMIT THIS MAY CERTIFY THAT Richard A. Benoit Insp. on Site — Foundations has permission to replace patio cement slab Insp. of Plumbing — Rough situated on 105 Lake Street, Florence 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 DISPLAYED IN A CONSPICUOUS PLACE HE PREMISES Certificate of Occupancy Building Inspector P�INP