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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. Sign�ure f • cant �jJ �' Address lc �t� j Application date CUj , /he I( /"� �i r 7�I�t �efi'.L� /1 /3 -Z 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 Date Permit or Approval Check Obtained Number By Permit or Approval Check l A Date i P 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 y. Building Use Group Permit issued 4 ,_. f ��� <i�l l i 3 / 19 _ Building Fire Grading Permit Fee $ Live Loading Certificate of Occupancy $ Occupancy Lood Approved by: Drain Tile $ £ sr4 '`. Plan Review Fee $ TITLE r 1"4 • • - CITY OF NORTHAMPTON MASSACHUSETTS OFFICE of the INSPECTOR of UILDINGS / +�- Page /3 P Plot APPLICATION FOR INSPECTOR ZONING PERMIT AND BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: I, I1, 111, IV, and IX. 0 ZONING / I. AT (LOCATION)/ 16-41--.64-- DISTRICT_V / _ LOCATION (NO.) (STREET) OF BETWEEN /00 AND BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE H II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D —1 73 A. TYPE OF IMPROVEMENT D. PROPOSED USE - For "Wrecking" most recent use m m 1 I I New building Residential Nonresidential 2 I I Addition (1/ residential, enter number 12 ri One family 18 I I Amusement, recreational of new housing units added, if any, in Part D, 13) 13 I I Two or more family - Enter 19 Li Church, other religious number of units ---)- f - - - - 20 VII Industrial 3 I Alteration (See 2 above) 14 ri Transient hotel, motel, 21 Parking garage 4 I I Repair, replacement or dormitory - Enter number 22 I I Service station, repair garage 5 I Wrecking (If multifamily residential, of units - .. ). 1 enter number of units in building in 15 I 1 Garage 23 Li Hospital, institutional Part D, 13) 16 n Carport 24 1 1 Office, bank, professional 6 I I Moving (relocation) 17 Li Other - Specify 25 Li Public utility 7 I I Foundation only 26 1 I School, library, other educational B. OWNERSHIP 27 r—I Stores, mercantile 8 1 (individual, corporation, 28 I I Tanks, towers nonprofit institution, etc.) 29 Ei Other - Specify 9 I I 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 $ 4)50 UG " 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 1 a. Electrical , ttii N1 N1 ��,-r4 b. Plumbing ' n c. Heating, air conditioning d. Other (elevator, etc.) 3 / �� 11. TOTAL COST OF IMPROVEMENT $ ) & .(4) 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 fl Masonry (wall bearing) 40 L; 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 /l o 321 Structural steel dimensions t -'�C ' 33 I I Reinforced concrete H. TYPE OF WATER SUPPLY `0 `61 34 p Other - Specify 42 A Public or private company Total land area, sq. ft. 43 L_ Private (well, cistern) K. NUMBER OF OFF- STREET PARKING SPACES 51. Enclosed F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 35 k Gas Wi ll there be central air 52. Outdoors J 36 L Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37 I r� Electricity 44 I Yes 45 rx No 53. Number of bedrooms 38 L i Coal 39 n Other - Specify Will there be an elevator' Full 54. Number of 46 L 1 Yes 47 X No bathrooms Partial DEPT. BUILDING INSPECTIONS BUILDING z ° , , <,,.._ 212 Main Street $a :> Northampton, MA 01060 PERMIT 18D - 4 VALIDATION DATE November 13, 19 87 PERMIT NO. 762 APPLICANT William Mock ADDRESS 106 Damon Road Owner (NO.) (STREET) (CONTR'S LICENSE) PERMIT TO Alteration l_ 1 STORY Industrial DWELL UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) 100 Damon Road ZONING GI AT (LOCATION) DISTRICT (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: permit to put in new stairway and windows on existing building VOLUME ESTIMATED COST $ 2 �nf _ 0 PER 10.00 (CUBIC /SQUARE FEET) OWNER Same as Applicant c BUILDEPT. ADDRESS Same ac Appl Kant I S BY C 3?_ir WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pINT p