29-254 (7) VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES -
IX. SITE OR PLOT PLAN — For Applicant Use
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44 4441
BOCA FORM APEBP — 669 C1969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and .State ZIP code Tel. No.
Owner or
Lessee
Builder's
2. i 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.
Sign u of applic�a-4 t ' Address Application date
DO 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 $ 1 A
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date D
Permit or Approval Check Obta ned Number By Permit or Approval Check Obtta tned 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 DEPARTMENT USE ONLY
Permit number
Building / Use Group
Permit issued 1�V _�• f�T 19 �
Building r00 Fire Grading
Permit Fee $ ao Live Loading
t
Certificate of Occupancy Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee
NOTES and Data — (For department use)
t
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 PLAN EXAMINATION AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: I, It, 111, IV, and IX. O
ZONING
AT (LOCATION) x�, i�Q°+- �"z�i -w� 6$-J 7 .�Y.t..d DISTRICT(L h A
LOCATION TNO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
V1
11. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
m
1 ❑ New building 9 Residential Nonresidential
2 ddition(If residential, enter number 12[)�One family 18 ❑ Amusement, recreational
of new housing units added, if any,
in Par[ D, 13) 13 F-1 Two or more family - Enter 19 ❑ Church, other religious
number of units- - - - -�
3 F-1 Alteration (See 2 above) 20 ❑ Industrial
14 ❑ Transient hotel, motel, 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory - Enter number
5 ❑ Wrecking (If multifamily residential, of units ------- - -- 22 ❑ Service station, repair garage
enter number of units in building in 15❑ Garage 23 ❑ Hospital, institutional
Part D, 13)
16 ❑ Carport �� 24 E] Office, bank, professional
6 ❑ Moving (relocation)
17❑ Other - Specify r�c��l 25 ❑ Public utility
7 ❑ Foundation only
��� � 26 ❑ School, library, other educational
B. OWNERSHIP =s-"r 27 ❑ Stores, mercantile
8 ❑ Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 2=� �ri�D 29 ❑ Other - Specify
9 ❑ Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential - Describe in detail proposed use of buildings, e.g.,. food
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,,,,,,,,,,,,,, school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office building at industrial plant.
To be installed but not included If use of existing building is being changed, enter proposed use.
in the above cost
a. Electrical.....................
b. Plumbing .....................
c. Heating, air conditioning..........
d. Other (elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT I$ r
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
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 .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other - Specify 42 Public or private company 50. Total land area, sq. ft. ...........
43 �❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed .......................
35 ❑ Gas Will there be central air 52. Outdoors........................
conditiXelev o
36 Oil L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 ❑ o 53. Number of bedrooms..............
38 ❑ Coal
39❑ Other - Specify Will th Full..........
54. Number of46 ❑ o bathrooms
Partial.......
hereby certify that the.proposed work is authorized by the owner of record
and 1 have been authorized by the owner to make this application as his"
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET)_ (CITY)
APPROVED BY TITLE
DATE 19
DEPAR OF BUILDING INSPECTIONS � DEPT. FILE COPY
°°
9
N, NA. mho BUILDING �a
n ), Code PERMIT�l9 �`
29 - 254 e VALIDATION
DATE September 12119 79 PERMIT NO. 44o
APPLICANT Ronald Billieux ADDRESS 85 Qnerlwk Dive
(NO.) (STREET) (CONTR'S LICENSE)
/wy,�,,,,,,,,, NUMBER OF
PERMIT TO_yyyyMA t�C €1t[)Qe (�_) STORY QQ(].. u^ j11I ff i(ZQe DWELLING UNITS
(TYPE.. IMPROVEMENT) NO. (PROPOS USE)
AT (LOCATION) 85 Overlook Drives Floreme DISTRICT URA
(NO.) (STREET)
w BETWEEN AND
(CROSS STREET) (CROSS STREET)
w `
IL LOT
m SUBDIVISION LOT BLOCK SIZE
0 BUILDING IS TO BE FT. WIDE BY - FT, LONG BY FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
I (TYPE)
Ix
° REMARKS: k Constrnn t. exterior ann arete block exterior chimney & install Wood—
burning stove. No o^e, f-Kk4�+e l -4 (/�� **A7 O.-rr,dC, io-1•79 e"9kG
AREA OR (� �/y� PERMIT
VOLUME ESTIMATED COST $ ,L�+ ,00 FEE � �O�QQ
(CUBIC/SQUARE FEET)
OWNER Ryan ald & Margaret Sillieux
ADDRESS R5 O{r@r'look Drive, P1_0''enee BYILD G PT. z P_,A�
(Affidavit on reverse side of application to be completed by authorized agent of owner)