15B-012 (18) _ .... BUILDING (170v -
aia� E. PERMIT
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vAuoAn
�-// WTE 19 PERMITjli'�O.
SS
ADDRESS
1176.I1� f TR[[TI F— Itoxi`bf LICENSE)
(TYPOF
PERMIT TO I_) t MORYAp OWE!L IRXE'YNITS
E IMPRW{Y[M ) XO. IPROFOf{D W[I
2011X0
AT (LOCATION) DISTRICT
)x0.1 TR[[TI
BETWEEN AND
ILROtl [TR[[TI (CROS[ STREET)
LOT
`SU{DIVISION LT—BLOCK SIZE
BUILDING 19 TO BE FT. WIDE BY_---- FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN OOXSTRUCTION
TO TYPE - USE GROUP EASEMENT WALLS 01 FOUNDATION
y
IIEMARRS• 14k Q"
VOEUME I•V q E'I F EST)MATEO COST .P O 3 7' J fEIR OREMIT C� •/-
ICV[ /WVAR[I[[T) • i /'
OHNE
BuILOING
AODR A ar
WHITE — FILE COPY GR IEN - FIELD° C PY CANARY - APPLICANT COPY • PINK .ASSESSORS COPY
i
��oo
BUILDING
.Tl; u�� . !�/��' PEERMIT =. 1F �L
j��� *404 6 0 /&-s —/[r , l'- of L10 AT1 N
`DAtE / c Lf 1
)9 923 IT t1PERM0.
APPLICANT �7 ICOxiRy u[[xa[I
NUMBER
PERMIT TO C (_1 STONY ! DWELLING UNITS / —
ITO[01 IbBOY WLN NO. I.....[D UB{I
EONIXO
AT (LOCATION) DISTRICT
INO.1 .TR[[TI
BETWEEN AND¢Rose uR¢TI ¢a[u eTN[en
LOT
SUBDIVISION LOT—BLOCK SIZE
BUILDING IS TO BE IT. WIDE BV FT. LONG BY FT. IN XEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
REMAINS' Alt /
VREA O f- y( ' [� ESTIMATED COST $ L O J 7/V i EMIT 'Y0
OW XE BR3A ua, _I/ \L!/fJl
em Lo1HG 0 , /'�'
ADO; Z BY
WHITE - FILE COPY . GREEN - FIELD COPY [ CANARY - APP41CANT COPY . PINK - ASSESSORS COPY
e CITY, 1�.""NORTHAMPTON
►' 'B MASSACHUSETTS
* ! OFFICE of the INSPECTOR of BUILDINGS
e
Page /6,15Plot 14?— APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete oil items in sections: 1, 11, 111, IV, and IX. o
I. oisrAl�T
4-4
T (�CCATION
LOCATION A I"he. V tSTEEETi
OF BETWEEN C -
BUILDING (CROSS sTeEETi (CROSS STREET)
LOT
1BIBI1IsmN LOT BLOCK SIZE
EST
IL TYPE AND COST OF BUILDING — All applicants complete Parrs A — D A
A. TYPE OF IMPROVEMENT D. PROPOSED USE - Far"Wreding" matt rcEI use m
m
ti
1 New building Residential Nonresidential
2 Addnlon(1/residential, enter nwnber 12 ROE. family IB r� Amusement, recreplonal
o{ Pear bo u.g4rzr; units added, i{any, 13 ❑ Two or more family - E.,- 19 LJ ChmcF, other coli glom
in Pm,D, 13) number o/ tomes-- - - y 20 �� Ind-)-I
3 L Alrermron (See 2 above) 14 ❑ Trans ern
Foie), -mel, 21 �� POking ga,age
4 ❑ Repair, replaceme"r or d-tri). y - Fnrer number
5 ❑ W,eckire (it NE-114 mi(v residerz,lal, a/ unit- -y 22❑ Service siphon, repair garage
SET-number.{uniir - b-Iding in 15❑ Go,.9e 23 ❑ Nospn.l, npit.nonal
Part 1)' 13) 24❑ Office, bank, professional
6 F-1 Moving (relocation) 16 ❑ Carport
7 ❑ Foundation only 17❑ .mer - SPac Qy 25❑ Schaal,
utility
zs❑ Schaal, Im.arr, anter edeparr.nai
B. OWNERSHIP 27❑ 5mme, -er[onlile
8 Private (individual,Estirorporen an,
2E ❑ TINS, lower,
on arra). ;nsn ninon, Sir.) 29� Other - SO epi/v
9 �� PebGc(Federal, State'or
lapel gmemmenQ
C. COST (Orme ren,..) Nonresidential - Describe in detail prop aged use o1 buildings, e.g., food
pro ... lan apb;ne shoe, lau"dry buildi"g at hospiml, Eleme tory
10. Cop of mpro.emep................ - school, Secondary tore, entaoo college par heal eebool, aro king garage for
department of score, rental .)fine in)ding, ed,office be;Ip-p p J-e. of plant.
in be above
—Idll,d but not int luded lime of Suis ting building ie being changed, enter proposed use.
i 1.11
o. Elearl cal.......................
b. Plumbing .......................
c. Heating, air pondlno... -!
d. Other(elevamr, etc.).............
11. TOTAL COST OF IMPROVEMENT bqo 3211
III. SELECTED CHARACTERISTICS OF BUILDING — For new baildings and additions, complete Parrs E — L;
for wrecking, complete only Part 1, for all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYIPPEE OF SEWAGE DISPOSAL J. DIMENSIONSA43n
30❑ Masoy (wall bearing) 40 Pallid or pYva a company Numbm of sroneg.............Mason,, t
31 Woad Irene 41 P-oh. (Septic tank, .tar.) 49. Tpol square feet of floor area, y-0 all floors, based on uterior
32 Snucmral steel dint-,.ae .....................
33❑ Reinforced coprpe H. TYPE OF WATER SUPPLY
34❑ Other - ti0eci/y 42 Public or private ca-perry 50. Total land
d ore., sq. It. ...........
43 Pr;ape (well, c;grp n) K. NUMBER OF OFF.STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICA 51. Encl...it .... _................
35�� G.N Wlll '. be cenv.l of 52. Oeo.. ..._........._....._.
36 '❑ oil _ L. RESIDENTIAL BUILDINGS ONLY
37 Ele cn;Nry 44 Yes 45
3B Coal ' Na 53. Ne-bet of bedrooms..
❑J .............
39 ❑ Other - Speei{vWI II rM1em on elewrmn 1.112. ....
e
54. Nurn be, of
46 es 47 ❑ Na barVvaoms
Par al.
IV. IDENTIFICATION — To be completed by all applicants
Name Maaing address .er, s arv, —d slur, ZIP code Tel. No.
o t� ata Go
Les:ee
Bolds/:
y, ❑an:r No.
Coonecro � w
3. 1 ✓1
Archlrec —
Er, .r
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.
Slgnmare of appclicant Address Application data
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re d Check Plan Review Dare Plans B Date Plans g Notes
quire Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Do Obra tied Number By Permit or Approval Chec 01hip oed 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 35�.Z FOR DEPARTMENT USE ONLY
Permit number T
Building. Us, Grans
Permit issued 19�Z
Building Fire Grading
Permit Fee $ wjl yd
Live Loading
Certificate of Occupancy $ Occapancy Lard
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
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