17C-236 (4) ZONING •
DISTRICT
FRONT YARD
SIDE YARD SIDE - .
REAR YARD
IX. SITE OR PLOT
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, sircct, city, and State ZIP code Teel.yNe. '
Owner or
Lessee
•-- Vl
Builder's
L.
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.
SF' t e o f ap cant Address Application date
DO 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 $
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obtai ed Number By Permit or Approval Check Obtained 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
II. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number 6 ,31
Bui Iding. Use Group
Permit issued _ 6. 19 Ze2_
Building Fire Grading
Permit Fee $ ,/rJ_ C�� Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
CITY OF NORTHAMPTON
'B $ MASSACHUSETTS
OFFICE of the INSPECTOR of BU�IL�DINGS
Page Plot �3�° APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items) in sections: I, 11, 111, IV, and IX. O
ZONING I
AT (LOCATION)
LOCATION "°'' (STREET'
OF BETWEEN AND_
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
H
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
M
1 ❑ New building Residential Nonresidential
2 ❑ Addition(If residential, enter number 12,<One family 18 ❑ Amusement, recreational
of neu, housing units added, if any,
in Part D, 13) 13 L❑ Two or more family - Enter 19 ❑ Church, other religious
number of units- - - - --)w—_ 20 ❑� Industrial
3 Alteration (See 2 above) 14 l
l
h
i
Transent hotel, mote ,
❑ 21 Parking garage
4 Repair, replacement or dormitory - linter number
5 ❑_ Wrecking (It multi family residential, of units ------- - -- 22 ❑ Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional
Part D, 13) 16 ❑ Carport 24 ❑ Office, bank, professional
6 L, Moving (relocation) r' 25 Public utility
17 Other - Spe c iJy �1z.G ❑
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP '0, Q1C!w- :•�"27 ❑ Stores, mercantile
8 Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 1!/e=gt-, �_4. -vLQ. 29 ❑ Other - Specify
9 D 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 Is
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 1V.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
30❑ Masonry (wall bearing) 40,N<Public or private company 48. Number of stories...............
31X Wood frame 41 ❑ 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
S fci 42 Public or private company 50. Total land area, sq. ft. ...........
34 � Other - p� Jy �- 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 J Oil conditionin
--_- L. RESIDENTIAL BUILDINGS ONLY
37 l i Electricity 44 'L No Yes / 45 -� No 53. Number of bedrooms.............. /
38 (� Coal
39Other - SpeciJy Will th a be an elevator? Full..........
54. Number of
46 ❑'� Yes 47 No bathrooms
- Partial.......
."'?
t
INSPECTION RECORD +�
DATE NOTE PROGRESS - CRITICISMS AND REMARKS INSPECTOR
•
U-4
t�.
F t
DEP isamm OF WILDING INSPECTIONS FIELD COPY
i
212 IN
,: STREET
OR T, MA. 01060 BUILDING
17c - 236 PERMIT
DATE October 22 19 AID PERMIT NO. 638
,
APPLICANT _J } ADDRESS 7 afT[�iTPl
`^��� _ (N0.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO (-3_) STORY DWELLING UNITS
TYPE F IMPROVEMENT N0. (PROPOSED U ) I
ZONING
AT (LOCATION) T� Hardwal l DISTRICT[1tt8
(NO.) (STREET)
a BETWEEN AND ,
�o (CROS S ET) (CROSS STREET)
rn
LOT
B. SUBDIVISION LOT BLOCK SIZE
a
0 BUILDING IS TO BE 4 FT. TOUP E BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
® J
0
Z TO TYPE USE BASEMENT WALLS OR FOUNDATION !
(TYPE)
LL REMARKS: ifL i metAl b*4tom rhiimer ATwd jmrR4Bjt ste-Y@ ein St- floor
I
i
AREA OR A PERMIT
VOLUME ESTIMATED COST . _, �.yVQO FEE . 1f1 (lam- +
(CUBIC/SQUARE FEET)
OWNER JOVE Pepper, Lessen BUI DING DEPT.
ADDRESS 73 Bar�ElZ S�� Northampton, Maw 01060 BY
� t' �-r F� '
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