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N N� Z 11W� Li a. ` � K SJ j Oj V W 3'- _ � v a4 „� � c{ � ia•w° " a4 0 ��TT �t pps, �<< Fi q11 �o � N i w �j! ` t 8� og J8 q°N 3 9a 9 � L�N �`; ? z31i u CL 4 F 7 m G a<C Y1 M i .- N-Z 7 -Oi O 2 Z a C� U m N A mt m r. COs O 2 O S ai < f°-m W d o x px r u j z F g 2F o o o A dL s g ; o no :9= I � 1 ' � 0 ;o W Cie AE m In 0 u Diu° i i 4 � 0. FT. Daup . . . . . . . . . . . . . . . . . . _ . WD Z. . . . . . . . . . . . . . . . .. . . . . . . . . . . Z� r 0 3 . . . . . . . . . . . vvo Z Olp SA M rn '1%VVI IUANT 1NUI 1V r ILL LIN OvMjr,0^"UV G l nao"A4• --- A lication for a Dwelling Permit pp a Northampton,Mass. . . '�! . -. . . . . . . . . . 191,,.J. • Telephone No. . . .�.� :b � . . . . . . . . . . . . 7b the Supt.of Buildings: Application for a permit to build is herelM made acc ng to the following:- �} .1. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lot No. . 1. Location, Street and No. . . .�`.1�. . . . . .. . . . . (�f 2. Nearest cross stree/t . . . . . . . . . .&1l11V. . . . . . . . . . . . . . . . . . . . . . . Size of lot . . . . . . �1 'i.�. . � �. . 1:�/ 3. Owner's name . . . .1`�1�GLev\t . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . .. . . . . . . 4. Architect's name . . . . . .`. . . . . Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . .- . . F 1. `�,�-.`J� 5. Builder's name ,� �, . t'. �V4. . . . . . . . . . . . . . . . . . . Address . Mass. Construction Supervisor's License No. . . . . . . . . . . Expiration Date . . .�.�.�. ,7. .�. .1 . . . . . . . 6. Use of Building:One-family . . . . . . . . . . . . . . . . . . . . Two-family . . . . . . . .. . . . . . . . . . . . Other . . . . . . . . . . . . . . . . . . . . 7. Number of rooms in each family unit: . . . . . . . . �7. . . . . . . . . . . . Number of Bathrooms . . . . . . . . . . . . . . . . . . . . . . 8. Is there a garage attached? . . � . . . . . .vvvk : L . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . 9. Size of building . . . . . . .a 4.�c. .`6. . . . . . . . . . . . . . . . . Square footage . . . . . .l . . . . . . . . . . . . . . . . . . . . . . . 1 10. Number of stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1. . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . 11. Distance from finished grade to high point of roof . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Type of construction . . . . .`pl.-4h . .vx(?4. . 13. Distance from building to street line in feet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . 14. Distance from building to side lot lines in feet:Left . . . . . . .).-) . . . . . . . . . . . . . Right . . . . . . . . . . . . . . . . . . . 15. Distance from building to rear lot line in feet . . . . . . . . . . . .S . . . . .v . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. Is a plot plan being filed with this application? . . . . . .kIruce. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . .. . . . . . . 17. Species of framing lumber:DF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . Other . . . . . . . . . . . . . . . . . . . . 18. Are all structural conditions noted on drawings? . . . . . . . . . . . . • . . 19. Nature of land upon which the structure will be erected: atural . . . . . .V. . . . . . . . . . . Filled . . . . . . . . . . . . . . . . . . . 20. Depth of basement or cellar floor below finished grade u4. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21. Material of foundation walls lull... . . . . . . . . . . . . . . . . . . . . . . Thickness in inches . . .M. . . . . . . . . . . . . 22. Type of roof:Flat . . . . . . . . . . . . . . . . . . . . . . . . . . . .ii. . . . . . . . . . . Pitched . . . .3/1 . . . . . . . . . .. . . . . . . . . . . . . . . . . . 23. Material or roof covering . . . . iiY . .. . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24. Method of heating . . . .t Q. . . . . . . . .. . . . . . . . . . . . . . . . . .. 25. Will the building conform to the Building and Zoning Ordinances? . . . .. . . . . . • • • • . . • • 26. Septic Tank? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . City Sewer? . . . . . . . . . � . . . . . . . . . . . . . . . . . . . . . . . . . . 27. Construction within 100 ft. of wetlands? . . . . . . . .V1\0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28. Construction within 100 year flood plain? . . . . . . . .y°\Q. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29. Estimated cost:Total $ . . . . . . . .'1T1.J .flu( No building or structure which is erected or altered,shall be used,in whole or in part,for any purpose until a certificate of occupancy is issued by the Building Inspector. The undersigned certifies that the above statements are true to the best of his knowledge anlohbeli f. ti. . . . . . . . . . . . . . Signatu e f Contractor Signature esponsible ap i nt WRITTEN D CRIPTION OF WORK TO BE DONE . . . . .E0.�0. . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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