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17A-219 (3) Location..................................................................... PermitNo. ................................................................. Application for other than a Dwelling Permit Granted........................................... 19 To .............................................................................. NOTE:IN ORDER THAT THIS APPLICATION MAY B E ACCEPTED,THE DATA CALLED FOR BELOW MUST BE SO SET FORTH THAT WE CAN DETERMINE FROM THE APPLICATION AND THE ACCOMPANYING PLANS WHAT THE EXISTING CONDITIONS ARE AND WHAT THE FUTURE CONDITIONS WILL BE. Plans,in duplicate,must be filed with this application before a permit will be granted,one of which,upon issuance of the permit shall be kept at the site during the progress of the work. New...............❑ Addition........❑ No.................-D, Zone..................., Type..................., Map...................., Parcel..................... Alterations ....❑ Repair............❑ CITY OF NORTHAMPTON Demolition....El MASSACHUSETTS Application for other than a Dwelling Permit (To be filled out in ink OR on a typewriter) To the Building Inspector: Date.............................................. 19 ...... Application for a permit is hereby made according to the followm* :- _ 1. Location, Street ano-�o.....�.( .. ...;1 }f: .h. !1�1 ...�C'..1..,�.e:4° f........ k 2. Nearest cross stre .. j........ .i r:2......... ... ..................... .. ............... Lot No....... ........ 3. Owner's name.... A.L.L1.0 L 1i�NN.��Address ....�.��..,�L!�....F:�:�.� �..... 4. Architect's name......................................................................... Address ............................................................. 5. Builders name -�.. . Address ......... . . .. .. . ............... 6. Use of building, Present..................................... Proposed ....j.41�1.Q. . .............................................. 7. Building fronts on how many Streets?...Uv..e................................................................................................... 8. Is building in fire district?........................................................................ ....................................................... 9. Size of building,Width in ft. .....40................ . Length in ft............. ......., Height in ft........................... 10. Distance of building from Street Line/LW L, left lot line.76:f right lot line.g. f:-, rear lot line........... 11. Type of construction(check one): 1-A........... 1-B .......... 1-C .......... II.......... III.......... IV.......... V.......... Stories B 1 2 3 4 5 6 7 Roof Story heights in ft. Thickn's of walls in ins. Material of walls Material of floor/roof Design live load Design dead load Occupancy or Use No.of persons/families No.of stairs 12. Soil under footing is................................................................................................................................................. 13. Depth of footing below grade................................... ft. Will piles be used?................................... 14. Area of entire building(Present plus new) . .:: � ............ sq.ft. 15. Type of roof-flat....................... pitched...... ........ Material of roof covering:f:.., .�.. ::..................... 16. No.of elevators.............. Method of heating./'s.I d..... System ................................. Fuel ................................. 17. Are live loads noted on drawings? ............... Are all other structural conditions noted on drawings? ................... 18. Building(will be)(is)equipped with sprinklers? "" ............ With sprinkler alarm? 19. Is building to be used as a factory,workshop or mercantile or other establishment employing 10 or more persons? .................................................................................................................................................................................. 20. Is building to be used as an office building,dormitory,hotel,family hotel,apartment or boarding house,lodging house or tenement house having 8 or more rooms above the second story?........... ................. 21. How many exits(per floor)to street? ...................................................................................................................... 22. Is building a"Place of assembly"as defined by the General Laws? ........::. ........................................................... 23. Will building conform to the General Laws? ......................... Building and Zoning Ordinances?......................... 24. If a garage,distance from nearest building? ........................................................................................................... 25. If an addition,alteration or demolition,when was building erected?....................................... .............................. 26. Estimated costs:- The undersigned certifies that the above statements are true to the best General$........ ..............I..... of his/her k wledgrnd belief Plumbing......................................... //........�v.... - or engineer ::..................... Gas Piping '(�' Signature of owner,architect ....................................... Sprinklers........................................ WRITTEN DISCRIPTION OF WORK TO BE DONE Heating ........ (Use blank half of reverse side,if necessary) .................................... Electric............................................ ............................................................................................................... Other............................................... ................ .......................................................................................... Total$.......x.17 ........................... ............................................. . .......................................................... P DINT 8FI P Date Filed � ) File No. - ZO ING PERMIT APPLICATION (510.2) 1. Name of Applicant: Address: 11/y - i=�, (E= a� (�, a,u� f:--,Telephone: < <- 2 . Owner of Property ` Address: Telephone: 3 . Status of Applicant: 'X~Owner Contract Purchaser Lessee Other (explain: ) 4 . Parcel Identification: Zoning Map Sheet# /)4 Parcel#,-- d Zoning District (s) (include overlays) 4ieri Street Address Required 5 . Existing ro ose Use of Structure/Property (if project is only interior work, skip to 6) Building height %B1dg. Coverage (Footprint) Setbacks - front - side - rear Lot size Frontage Floor Area Ratio `s- - %Open Space (Lot area minus building and parking) Parking Spaces Loading Signs Fill (volume & location) 6 . Narrative Description of Proposed Work/Project: (Use additional sheets if necessary) r' 7 . Attached Plans: Sketch Plan Site Plan 8 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. > Date: �-S � Applicant I s Signature: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - j THIS SECTION FOR OFFICIAL USE ONLY: Approved as presented/based on information presented Denied as presented a Qn f ' Denial : igna of Buildi Inspector D 6.t NOTE: Issuance of a zoning permit does not relieve an applicarrt's burden to comply with all zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Publio Works and other applicable permit granting authorities. PERMIT APPLICATION CHECK LIST Yes No D t 1 . Zoning Form Application 2. Permit Application 3. Homeowner statement if a licable Lic . ## if not 4. 2 sets of plans 5. Curb cut 6. Water Department mamo 7. Permit fee - check onl,y -( O V �. Special Permit reo fired with dee 9. Under section 127 - MR 78n City of Northampton REQUIRED INSPECTIONS s 1 . Footings and Walls ' BUILDING DEPARTMENT 2 . Structural Components in Place t� 3 . Complete Building No. 243 Office of the Building Inspector Date May 6, 1992 19 B U1 DING P RMIT THIS MAY CERTIFY THAT Richard W. Venne Insp. on Site — Foundations has permission to . Erect a shed 8'xlo' Insp. of Plumbing — Rough 164 North Maple Street situated on 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 of issuance, if not started. 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 CON ' U ; US ;ACE ON THE PREMISES Certificate of Occupancy Building 1'nspector P-Q�