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17A-240 (5)
For ALL buildings within Fire District and for other buildings costing $10,000.00 or more, plans and specifications must be submitted to the Inspector of Buildings for examination and approval. If building is to be moved give details relative to proposed location as for a new building. Application for Permit to Build /Z; =- Northampton, Mass,. .». . .... ...»..�........19��.. To the Inspector of Buildings:— The undersigned hereby applies for a permit to build, move, alter, or repair, according to the following specifications.- ., 1. Owner's name ..:..»...,.�.a.`.�..»,�...� :?. ...»».. ....t,.........1 ........._..........»...............................».....................»................. 2. Owner's address . ... ...... ........... .. 1. » ..............»...».. `.»'.»...._...................»................. .......... 3. Architect's name .......................»........................._..........................»....»......................_.............»..................................................................... 4. Builder's name ...........».»....»......................»....»..........».................»............................_.........._.............»................»....................._................. 5. Builder's address ...................................................................... ...........................».........._....................................». ..»....».......... � . ......... t`»... ....�.�.`..;s y 6. Location of Buildin g. Street No. ........ .....................» . .....:.............. fi 7. Is this a removal or new building..............»........................».............»....».......»......................................................... . ................... 8. If removal, from where .......................................................................................................................................................................... 9. What is the purpose of building ..... ..»I.»................!:�................ .............�` ..........,.f.j .... ..f�..k, ..R» ....................... 10. Material of building ...................4............_....... . ...................................................................._...........................»......................................... 11. If a dwelling, for how many families ................. .................».....Number of rooms ................................................... 12. Is there to be a store in the building 'F --, 13. Size of building, No. of feet front .....»...»............:No. of feet deep .....».::.° . :.; No. of stories .................... 14. Size of ell, No. of feet front .......... .® ...; No. of feet deep ................ ..; No. of feet high ..........:»--,.... 15. Size of Lot ..............».......»...........................»......».......................Feet Wide ........ ;: : .......».... .. Feet Deep .......... " -° .......... 16. How near the-line of street ..................................................................».............................................................................................. 17. How near the line adjoining lot. Right................._................; Left...........»......................; Rear................................ 18. Nearest building is ...............................feet in a r. » .... . .. .... .............. direction ....................................................... 19. Material of the floor ............. :��. � .. . ...................................................... 20. Size of timbers, 1st ............»._.....; 2nd .....»....»...--;3rd .......................: 4th ........... ; 5th ....._....................... 21. No. of feet span............................................................... ; Distance on centers ...................................................................».. 22. Will the building be erected on solid or filled land ..........................._............................»..................................»............. 23. What is the material of foundation .....»...».»...................»....».......»....»....»...................»....».......; Footing ....................... 24. Will the roof be flat or pitched ...........».»..............................................; Covering....................»....»....................................... 25. Heat; steam, hot water, furnace, stoves.....».................................; Power oil burner .............................»................ 26. Fireplace .....».............».......»....»..........»......................; Insulation .........................................................................................................».. 27. How many sinks , Toilets ...........; Lavatories ........; Bathtubs....»..; Showers............: Settubs ......... 28. City Service; Water ........................Sewer .......................; Road Surface .........................; Sidewalk .................». 29. Is lot on accepted street .............»................................................................................................................................_.....»....». 30. Estimated cost (must be filled out) ........»...........». ��......».....................................»....».........................».....»....... Applicant agrees to give the Inspector of Buildings 24 hours' notice before lathing or plastering this building. This building will conform to the requirements of the law. Signatureof applicant.. ._. .. ......... .»....».» a..».... »...�....»,.1.....»....» . ..».:»................»...................»................................ No....»,»?... .»,» ........... REMARKS t' ....» «. . .. (/7� ..................... ...»... . ....».......»....»....».......»..........»....».......»...._.».......»........... ...t.................................. .»...............................».......»....»...............».. --------------------- ...».......»...........„......»...............................»....».»....».».............».......».».......».............................................................................................................................................. ZONING PERMIT .�r T< V P Yo. Lot APPLICATION _ Zoning Ordinat:ce Secti^n 10.:' "ece_i_rr c?: File T,'o. Flan File J,vner �c ' p �' Applic. t Address LL ,�"-�= = ` : � jj( .e ,Aches ���� ' _ hnnc, Telephone _ � �` Telc! This section is to be filled wit in c1crordc.tice .-J th U e "P,I)i-e of Dire nsionr-1 and Density Re latione:. (Z. . A1 'TICLF; VI) _ Zoning Irre Lot Front Dci,th Sct1'.acl,r is%.Bld. 11in. Op. District Area '!"J.dt)I Front Side > LL,r —Cover. T Space P ast Existn.r,- _.... _ ,5 --� ',�� r ,� °� o 0 RB resent 1propoced ,lark the appropriate lox to lndic�)te the use of t11r percel: Q Non-Conforming Let ';,rid/or f;trticturc. S?)ecify Residential ;inCle Fr ily I1iiit. =Vulti-Fanily Duplex =Other [Q Business Q Industrial Q Institutior�l Q Subdivision Q R°� u.l ; r ((Q�� h.U.D. (l ther Q Subdi.visinn with = Planning I'o<ot-d Approvnl : = Zoning Board Approval (Special Permit 1().; I hereby certify that the proposed work is authorized-by-" the owner of record and I have been authorized by the owner- to make this .apptidation. as his authorized agent. SIGNATURE OF AGENT ADDRESS (NUMBER) (STREET) (CITY) APPROVED BY TITLE DATE 19 DEPT. FILE COPY Z City of Northampton BUILDING Massachusetts PERMIT office of the Inspector of Buildings VALIDATION DATE 19Z6 PERMIT NO. �© APPLICANT ADDRESS f(NO.) rTREET) (CONTR'S LICENSE) WEBLLIRNG OF UNITS PERMIT TO (_) STORY TYPE OF IMPROVEMENT) N0. l OPOSED USE) ZONING �/ , AT (LOCATION) DISTRICT^ (NO.) (STREET) m BETWEEN AND b (CROSS STREET) (CROSS STREET) m LOT LL SUBDIVISION LOT BLOCK SIZE m Q U O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION m O .�� Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION � ) (TYPE) 0: O 4 LL REMARKS: AREA OR PERMIT r VOLUME ESTIMATED COST $ FEE (CUBIC/SQUARE FEET) OWNER BUILDING DE ADDRESS BY (Affidavit on reverse side of application to be completed by authorize f owner)