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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
1 /
Owner or t_.FJ., G ,(
Lessee
- 1 / Builder's l'J
2. % v G. Y i 1 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.
Signafi�re f applicant Address Application date
"I � 7
V � �lt 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 $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number By Permit or Approval Check Date Number B
Obtained Obtained 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 (7 FOR DEPARTMENT USE ONLY
Permit number x
Building 1 Use Group
Permit issued I !in.1 c_ fq
Building � Fire Grading
Permit Fee $ jL' ' >
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved
Drain Tile $
Plan Review Fee $
TITLE
, �.. CITY OF NORTHAMPTON
�. .e MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
t
Page L-i Plot Gf� APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
I
�y,;;1 � ) ZONING
I• AT (LOCATION) 1� �i� �( C DISTRICT, Jv
LOCATION (N d.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
IL TYPE AND COST OF BUILDING — All applicants complete Parts A — D ;a
A. TYPE OF IMPROVEMENT D. PROPOSED U,,SE — For"Wrecking" most recent use m
r M
1 ❑ New building Residential Nonresidential
2 ❑ Addition(if residential, enter number
12� One family 18 ❑ Amusement, recreational
/new housing units added, if any,
Part D, ]3) 13 F-1 Two or more family - Enter 19 ❑, Church, other religious
in
number of units- - - - --> 20 ❑J Industrial
3 ❑ Alteration (See 2 above) ��
14 ❑ Transient hotel, motel, 21 parkin
4 ❑ Repair, replacement or dormitory - Enter number r 9 garage
5 ❑ Wrecking (11 multifamily residential, of units ------- - i 22 L� 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
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
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,,,,,,,,,,,,,, -I i l 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..................... f
l
� f❑ rig y%4
b. Plumbing ...................... �
c. Heating, air conditioning........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $
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. 4t. ..........
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
37E] Electricity 44 Yes 45 No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other - Specify Will there be an elevators Full..........
54. Number of
L bathrooms
46 1 Yes 47 No Partial........
DEPT::'OVWILDING INSPECTIONS BUILDING ;° `/y
212 Main Street 0
Northampton, MA 01060 PERMIT <a
29 - 92
VALIDATION
DATE March 14, 1988 ,9 PERMIT NO. 118
APPLICANT John Diaoins ADDRESS 59 Conz Street On File
IND.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO AltPratAnnC (`) STORY One Fami I DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 46 Brierwood Drive ZONING
DISTRICT URA
(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: nPrmlt to install hat.hronM In existing basement arpA
AREA OR VOLUME ESTIMATED COST $ r'nn nn FEEMIT j n n0
(CUBIC/SQUARE FEET)
I' r
OWNER b��Y+�:;c�e�trl+�+eiaer1nn �l f t .
BUILDI t `�
ADDRESS n--U i LQ l.ln�D i i y BY r
WHITE - FILE COPY . GREEN - FIELD COPY CANARY - APPLICANT COPY • PINK - ASSESSORS COPY PINf P dadh