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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.
Owner or aLWA
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.
Signature of plica Address Application date
D0 NOT WRITE BELOW THIS LINE
V. PLAN RE IEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
4 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
D Date
Permit or Approval Check Obttatned 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 FOR DEPARTMENT USE ONLY
Permit number
Building
Q�� Use Group
Permit issued 19
Building r�
Fire Grading
Permit Fee $ (//
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by: nn
Drain Tile $ �TP 6414�*
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�. MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
Page 2 Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. C)
ZONING
I• AT (LOCATION) DISTRICT
LOCATION N0.) s7REE7)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
A. TY E OF IMPROVEMENT D. PROPOSED USE – For"Wrecking" most recent use m
M
1 New building Residential Nonresidential
2 Addition(If residential, enter number 12F-1 One family 18 E] 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,
4 Repair, replacement 21 [__� Parking garage
p p or dormitory – Enter number
5 ❑ Wrecking (11 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 270 Stores, mercantile
8 Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 D 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 industri plant.
To be installed but not included If use of existing building is being changed, enter pr 6se use.
in the above cost /
a. Electrical.......................
b. Plumbing .....................
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $,
111. 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 D 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
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 F—] Yes 45 !�! No 53. Number of bedrooms..............
38 Coal
39 Other – Specify Will there be an elevator° Full..........
1 54. Number of
46 C 1 Yes 47 1,-1 J No bathrooms
Partial........
00
DEPT. OF BUILDING INSPECTIONS o f
i a BUILDING =1 I Q !
212 Main Street O l
Northampton, MA 01060 PERMIT
2 - 2 VALIDATION
Jul 16 _ 86 Na. 86
APPLICANT R. Russell Luce DAT�ADDRESS ' 6 oar 1- arms"`toac�
(NO.) (STREET) (CONTR'S LICENSE)
New Building Detached 2 Car Garage NUMBER OF
PERMIT TO (_) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
705 North Farms
Road ZONING RK
AT (LOCATION) DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE 24 FT. WIDE BY 24 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS; permit for the construction of a new 2 car detached garage
AREA OR 576 sq. ft. ESTIMATED COST $ 3,500.00 PER E MIT $ 10.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER Same as Applicant
ADDRESS
Same as Applicant BYILDIN
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - A SSORS COPY P ONIP