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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 �t y � 00 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plan Review Date Plans Date Plans Plans Review Required Check Fee Started By Approved By Notes BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL $ OTHER $ VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approval Check Obttaaired 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 VII. VALIDATION Building Z4,2 FOR DEPARTMENT USE ONLY Permit number Building- _ Use Group Permit issued , h— 19 Building ( Fire Grading Permit Fee $ _ Live Loading Certificate of Occupancy $ Occupancy Load Approved by: Drain Tile $ Plan Review Fee $ TLE CITY OF NORTHAMPTON 44 MASSACHUSETTS B OFFICE of the INSPECTOR of BUILDINGS Page 2-1 Plot_ _,�� A 7 APPLICATION FOR ZONING PERMIT AND INSPECTOR BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, I1, Ill, IV, and 1X. O ZONING I• AT (LOCATION) DISTRICT(! LOCATION NO.) (STREET) OF BETWEEN AND BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE N It. TYPE AND COST OF BUILDING — All applicants complete Parts A — D -a A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m m 1 New building Re idential Nonresidential 2 Addition(1/residential, enter number 1 One family 18 ❑ Amusement, recreational of new housing 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 ——————— — --) 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 ❑ Moving (relocation) 17 ❑ Other — Specify 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 (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food 10. Cost of improvement,,,,,,,,,,,,,,,, processing plant, machine shop, laundry building at hospital, elementary school, secondary school, college, parochial school, parking garage for, department store, rental office building, office building at industrial plant. 7'o 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 1$ III. SELECTED CHARACTERISTICS OF ETI LDING — For new buildings and additions, complete Parts E — L; for wrecking, complete only Part J, for alt' others skip to 1V. E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS 3 Masonry (wall bearing) 40 LA<Public or private company 48. Number of stories... 31A Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area, all floors, based o efv�. r 32 L❑ Structural steel dimensions +rC! 33 Reinforced concrete H. TYPE OF WATER SUPPLY 50. Total land area, sq. 4t. .......... 34 ❑ Other — .Specify 42 J Public or private company 43 Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed ....................... F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 35 L j Gas Will there be central air 52. Outdoors........................ conditioning?cond 36V] Oil _ L. RESIDENTIAL BUILDINGS ONLY _ Electricity 44 L� Yes No 53. Number of bedrooms............. 38 ❑ Coal 39 F I Other — Specify Will there be an elevator? Full.......... — 54. Number of 46 Yes 47 ❑ No bathrooms Partial........ �. n..r ,;t 'IDTs�;�+'�w.� . »»nz` �d.��.. ...'. " •.*«��& �:aa. .H} .^w,+.:.5e „y .r ,. 9�4i3�- Department of Building Inspections 212 Main Street rtha)zt&gW#f#Ma. 01060 BUILDING v. 29 _ 427 PERMIT a VALIDATION DATE April Ii 19 A2 PERMIT NO. t0_4 APPLICANT neborah T Thomas ADDRESS" 79 Golden Drive INO.) (STREET) (CONTR'S LICENSE) NUMBER OF PERMIT TO (�_) STORY $uj�$np DWELLING UNITS 1 - TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ZONING AT (LOCATION) 29 Golden Drive DISTRICT (MA (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: Sop al CA Permit 6564 dated 10(5181 for foundation Addition of sunroom 12' X 16' AREA OR PERMIT . QO VOLUME 7A? ESTIMATED COST $ 000 FEE -740 (CUBIC/SQUARE FEET) OWNER neborr-ob T--_Thomas BUlLDIaOE ADDRESS 79 Golden Dr Northamp tong 1MA. 01060 BY WHITE - FILE COPY . GREEN - FIELD COPY w CANARY - APPLICANT COPY • PINK - ASSESSORS COPY -1-104 W,- lD.' M Nkk A 1 � :6 4� 9 t fi IV up ,. Xl -lY y w sops lw WOO r r SU : X u t �° �, t "" # ' 212 tv"t mirth,*. 01060 BUILDININ12-4r PERMIT a a , ^� . e�l IDATION } DATES "ll to 19 PERMIT NO APPLICANT ADDRESS STREET). 1 (CONTR'S LICENSE) NUMBER OF PERMIT TO (—i—) -STORY DWELLING UNITS T P P OVEMENT) NO. PROPOSED USE) ZONINGb� AT (LOCATION) � - DISTRICTS:. (NO.) ($TREETI 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 CONF062M IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: teak YII @ pm=i1t (� # � fe=Ajk*,4mm s A4"ttso of misrom 12 ix 1* AREA{ ! VOLUME ESTIMATED COST $ �P,EEEMIT {y � (CUBICTSC ARE FEET) OWNER" Le BUILDIN DE ADDRESS BY I WHITE - FILE COPY . GREEN FIELD,',-,f PY CANARY APPLICANT COPY ■ PINK - ASSESSORS COPY Certified Mail Provides: • A mailing receipt (asianay)zooz eunr`oo8£wood Sd • A unique identifier for your mailpiece • A record of delivery kept by the Postal Service for two years Important Reminders: • Certified Mail may ONLY be combined with First-Class Maile or Priority Mail& • Certified Mail is not available for any class of international mail. • NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. • For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a LISPS®postmark on your Certified Mail receipt is required. • For an additional fee, delivery may be restricted to the addressee or addressee's authorized agqent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". • If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT: Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail addressed to APOs and FPOs. Postal Ica a CERTIFIED MAILT. RECEIPT C3 Provided) Ir (Domeek Mail Only;No Insurance Coverage Mium =11= 0 0 Postage $ O O Certified Fee i + �( PostMAA Return Reciept Fee Here M (Endorsement Required) —0 Restricted Delivery Fee l nt\(V5 r yf r-1 (Endorsement Required) L rq Total Postage&Fees C3 Sent To Richard & Dianna Ramsden ---- -------------------------i�eet,itpt:No:;-- 37S Brookside Crcle or PO Box No. c;ty.srare,zlP+4 Florence- MA 01062 2002