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IDENTIFICATION — To be completed by all applicants Name Mailing address — Number, street, city, and State ZIP code Tel. No, I' 20 C : CGC Owner or v r` r� `�' r' S'�`"p-r-I Lessee Builder's 2, 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. Signatur of applicant Add ress ` i �j A Application dote 1 y.n,C.1� ', a) 4, V+-G'r 7/ '�r'.J-�� W —*6 �j &—a -5_ � 1 30/";?7 00 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Required Check Plan Review Date Plans B Date Plans B Notes 9 Fee Started y Approved y BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL $ OTHER $ VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Date D Permit or Approval Check Obtained Number By Permit or Approval Check Obttaitned 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 �/'1 FOR DEPARTMENT USE ONLY Permit number Building 1, Use Group Permit issued L20f 19 �..��� Fire Grading Building Permit Fee $ Live Loading Certificate of Occupancy $ Occupancy Load Approved by: Drain Tile $ Plan Review Fee $ TITLE CITY OF NORTHAMPTON MASSACHUSETTS OFFICE of the INSPECTOR of BUILDINGS t Page Plot � ) APPLICATION FOR INSPECTOR ZONING PERMIT AND BUILDING PERMIT z IMPORTANT — Applicant to complete all it/ems in sections: 1, Iyl, 111, IV, and IX. O ZONING 1• AT (LOCATION) 1t�-��!+vy OI tV�. lJ "' ,^i�-+^— I�G ! DISTRICT LOCATION (NO.)` l 1 (STREET) ( j� OF BETWEEN L'�l r kA—" \ 1 AND BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE N 11. TYPE AND COST OF BUILDING — All applicants complete Parts A — D X A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m M --f 1 ❑ New building Residential Nonresidential 20 Addition(If residential, enter number 12 [✓❑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— — — — --1. 20 ❑ Industrial 3 ❑ Alteration (See 2 above) 14 Transient hotel, motel, 4 ❑ Repair, - 21 C� Parking garage replacement p p or dormitory — Enter number 5 ❑ Wrecking (Il multi family residential, of units ——————— — -i 22 �_� Service station, repair garage enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional Part D, 13) �I 16 �J Carport 24 Office, bank, professional 6 ❑ Moving (relocation) 17 Other — Sped/y 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 processing plant, machine shop, laundry building at hospital, elementary 10. Cost of improvement,,,,,,•,•,,,..,, d 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....................... O b. Plumbing ....................... C 'D 1 ? / .' c. Heating, air conditioning.......... G d. Other (elevator, etc.)............. 11. TOTAL COST OF IMPROVEMENT $ 3 OOD 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.......area, ... 31 �Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square feet n floor area, all floors, based on exterior � d 32 ❑ Structural steel dimensions ..................... . , 33 ❑_ Reinforced concrete H. TYPE OF WATER SUPPLY 34 ❑ Other — Specify 42 'Public or private company 50. Total land ores, sq. ft. ........... v 43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ...................... 35E:] Gas Will there be central air 52. Outdoors........................ 36 ❑ Oil conditioning.' L. RESIDENTIAL BUILDINGS ONLY 37 Lv�-Electricity 44 Yes 45 'r^ No 53. Number of bedrooms.............. 38 ❑ Coal 39 Other — Specify Will there be an elevators Full.......... J 54. Number of 46 Yes 47 ✓ No bathrooms - Partial....... NOW DEPT. QFRUUING INSPECTIONS BUILDING + . 212 Main Street 0` Northampton, MA 01060 PERMIT <a $10.00 J 29 20 VALIDATION DATE October 2, 19 87 PERMIT NO. 680 APPLICANT Thomas Lippie ADDRESS 29 Hickory Drive Owner [NO.) (STREET) (CONTR'S LICENSE) NUMBER OF PERMIT TO Add it i on (_) STORY QnP Family DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ZONING URA AT (LOCATION) 79 Hirkor� Drive DISTRICT 'o (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: pp}Mi t fnr thA addition of h;;tbrnom And Add i t i nn onto Px t St i nQ hedronm AREA OR PERMIT VOLUME ESTIMATED COST on FEE $ 10_00 CUBIC S DARE FEET) OWNER Same as Applicant 8U14 � '' • ADDRESS Same as Applicant' s BY WHITE - FILE COPY GREEN - FIELD COPY CANARY - APPLICANT COPY PINK - ASSESSORS COPY pjNT' ItP