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NOTES
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants `
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or ��6- -�,-. ` " �,.I'i11�.." ' `./ �•' „l t j �/ l �i ��� ��I�� / p -• f�C �!;
Lessee
Builder's
C 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 1 Address Application date
D0 NOT WRITE B E 6 W TvHIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans
Fee Started Y Approved BY Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approva I Check Date Number B Permit or Approval Check Number B I Ch Date umer
Obtained Y pp _ Obtained Y
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. / 1
' �' Use Group
Permit issued 1q
Building -
g Fire Grading
$
Permit Fee
Live Loading
Certificate of Occupancy $ Occupancy Load
App e y:
Drain Tile
Plan Review Fee $
TITLE
Q3 CITY OF NORTHAMPTON
B+ ~ MASSACHUSETTS
e OFFICE of the INSPECTOR of BUILDINGS
Page 0t Plot e_10 APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, III, IV, and IX. Q
ZONING
I• AT (LOCATION) �,J .��,f ' f ' 1� DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN -AND
BUILDING (CROSS STREET) CROSS STREET)
LOT
SUBDIVISION LOT_ BLOCK SIZE
V1
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
1 ❑ New building Residential Nonresidential
2 ® Addition(If residential, enter number 12 One family 18 ❑ Amusement, recreational
of new bousing units added, if any,
in Part D, 13) 13 ❑ Two or more family – Enter 19 ❑ Church, other religious
number of units– – -- – --). 20 ❑ Industrial
3 ❑❑ Alteration (See 2 above)
14 ❑ Transient hotel, motel, 21 parking garage
4 Repair, replacement or dormitory – Enter number
5 ❑ Wrecking (If multifamily residential, of units ––––––-- – -i 22 Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional
Part D, 13) 24 ❑ Office, bank, professional
6 ❑ Moving (relocation) 16 ❑ Carport / r'
17 Other – Specify p1 25 ❑ Public utility
7 ❑ Foundation only 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 ( it cents)ot Nonresidential – Describe in detoil proposed use of buildings, e.g., food
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,,,,,,,,,••..
r 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 than ad, enter proposed use.
in the above cost //
a. Electrical..................... C'l L'1 U
b. Plumbing ..................... fi
c. Heating, air conditioning..........
d. Other(elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $ JJJ JJJJJJ"''''
III. SELECTED CHARACTERISTICS OF BUIfLDING — For new buildings and additions, complete Parts E — Li
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 [,—Kl 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 ..................... 2 .r
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other – Specify 42 [K] Public or private company 50. Total land area, sq. ft. ........... L r (
S eci
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 ❑ oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 ❑ Yes 45 , No
�_ . 53. Number of bedrooms..............
38 ❑ Coal
39 Other – Specify Will there be an elevator? Full..........
� 54. Number of
46 ❑ Yes 47 L�j No bathrooms
Partial........
..,. .: .Ty.�-,� aa°�".. ,,a.z-.Wang ?.r.E g i .� :�.,
t ���
lepartment of Building Inspections
;12 Fain Street
fortha ton, MasS':"14601060 BUILDING o°
PERMIT
29 -SA08 VALIDATION
DATE October 24, 19 83 PERMIT NO. 620
APPLICANT Albert J. St. Onge ADDRESS 89 Sandy Hill Road Owner
(NO.) (STREET) (CONTR'S LICENSE)
Addition Fau it Y Rooim NUMBER OF
PERMIT TO I_) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 89 Sandy Hilt Road ZONING DIST'R ICT ITRA
(N0.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
18 22
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: permit for the addition of a fa. ly room; on. the back of existing house
AREA OR 396 s . ft. $ 500.00 PERMIT 28.00
VOLUME ESTIMATED COST $ F FE
(CUBIC/SQUARE FEET)
OWNER Albert J. St. Onge
ADDRESS $ any H1 1 oa , orence BY
WHITE - FILE COPY . GREEN - FIELD COPY a CANARY - APPLICANT COPY • PINK - ASSESSORS COPY