30A-032 (38) "•e DEPT. O� ILDING INSPECTIONS BUILDING
212 Main Street 04 '7 `
Northampton, MA 01060 PERMIT
30A - 32 VALIDATION
DATE Apri l 29, 19 87 PERMIT NO. 2_.19
APPLICANT Assnc._wRFCKTNr, ADDRESS Snrinrgfield
(N3'1 (STREET) (CONTR'S LICENSE)
PERMIT TO Repair/Replacement (_) STORY Industrial NUMBER OF
DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) Un Riverside DriyQ DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: P012ITiit to CQA4QN/Q LQXiStiRn rnnf A-nr- i•iJ-121dGWS anse-eeAd flaer and Feplaee
0,000.00 PERMIT s 40.00
ESTIMATED COST FEE
(CUBIC/SQUARE FEET)
atlery Building Assoc. �`✓ /1 ;, �
Main25 Northampton BBYILDI
FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY I,
��•� CITY OF NORTHAMPTON ,.
�+ MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
Plot ��
Page APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
I• Z b 1�•I�f,/• LO ZONING
AT (LOCATION)
0a. DISTRICT
LOCATION (NO.) . TREET) .
OF BETWEEN / X dE/ AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vr
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
—f
1 ❑ New building Residential Nonresidential
2 ❑ Addition(1/ residential, enter number 12❑ One family 18 ❑ Amusement, recreational
of new bo using units added, if any,
in Part D, 13) 13 E:] Two or more family — Enter 19 ❑ Church, other religious
number of units— — — — -- 20 ❑ Industrial
30 Alteration (See 2 above) '
14 ❑ Transient hotel, motel, 21 Parking garage
4Repair, replacement or dormitory — Enter number
5 Wrecking (1J multifamily residential,
of units ——————— — -- 22 ❑ Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional
Part D, 13)
6 ❑ Moving (relocation) 16 ❑ Carport 24❑ Office, bank, professional
7 ❑ Foundation only 17 F__1 Other — Specify 25❑ Public utility
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8 Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 ❑ Other — Specify
9 ❑ 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 $ 10 ,606
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — Ll-
for
;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 Public or private company 48• Number of stories...............
31 Wood frame 41 Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 ❑ Structural steel dimensions ..................... Q06
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other — Specify 42)< Public or private company 50. Total land area, sq. ft. ........... Z a /
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35S Gas Will there be central air 52. Outdoors........................ I �Z
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 ❑ Yes 45X No 53. Number of bedrooms.............
38 ❑ Coal
39 ❑ Other — Specify Will there be on elevators Full..........
54. Number of
46 ❑ Yes 47No bathrooms
�
-- Partial.......
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
Owner or
,.� j Sot.
Lessee �6•Q��O
Builder's
2• S0( r k/• 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.
Signature of applicant Address Application date
Z
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 Approval Check Obta ned Date Number By Permit or Approval Check ObtDate
a ned 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
VII. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building /� : p Use Group
Permit issued / ��%�'GLt , 19 O
T
Building Fire Grading
Permit Fee $ �/� •�.CJ Live Looding
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
NOTES and Data — (For department use)
C-
VIII. ZONING PLAN EXAMINERS NOTES
SIDE YARD SIDE YARD
IX. SITE OR PLOT PLAN For Applicant
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