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NOTES and Data — (For department use)
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IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or C.) I 'lac)/ �� - W r-er 5'r j Lc �S •l�� /^�;�, (0p6;360,(1
Lessee t r'1 C V /C� ! / 3 p
2. &��aY COus, /t/ r 1ff\ RD / JQ(� �N h/. LBcenser•No. -S&57
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 authori -d agent and we agree to conform to all applicable laws of this jurisdiction.
Signature of applicant / Address �(� ��j� Application date n.
.617 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
9 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check I. ADD
ITI 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 Use Group
Permit issued 1 19
Building ±' Fire Grading
Permit Fee $ !�/+°
Live Loading
Certificate of Occupancy $ Occupancy Load
• .. by:
Drain Tile
...IL" -of . -
Plan Review Fee $
TITLE
' • , 0 , -' 1 ` CITY OF NORTHAMPTON
A MASSACHUSETTS Al.'. ,,,,,,,,
'�`�.,�' • ' OFFICE of the INSPECTOR of BUILDINGS 40
f ` ' ! `� , /6 Plot l o t R
Q`' APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: I, II, Ill, IV, and IX. !, 0
I. AT (LOCATION) ! / •/ / /,4 oc DI C gA
LOCATION (NO.) (STREET)
OF BETWEEN �'',4:: /ts...1 (T— AND C N, ,JI -E f' l.k R l�
BUILDING (CROSS STREET) (CROSS STREET)
L0T /�/'/" S'
SUBDIVISION LOT BLOCK SIZE ��--!/
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D -I
xi
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For "Wrecking" most recent use m
m
1 New building Residential Nonresidential
2 n Addition (If residential, enter number 121One family 181 1 Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 Ti Two or more family - Enter 19 L J Church, other religious
number of units- - - - -10- 20 1 1 Industrial
3 I 1 Alteration (See 2 above) 14 1 I Transient hotel, motel,
21 El Parking garage
4 El Repair, replacement or dormitory - Enter number
of � 22 Ti Service station, repair garage
5 � � Wrecking (If multifamily residential, / units - -
enter number of units in building in 15 Garage 23 jj Hospital, institutional
Part D, 13)
16 Carport 24 H Office, bank, professional
6 [ I Moving (relocation)
171 I Other - Specify 25 H Public utility
7 1 j Foundation only
26 1 1 School, library, other educational
B. OWNERSHIP 271 1 Stores, mercantile
8 1 Private (individual, corporation, 28 Ti Tanks, towers
nonprofit institution, etc.) 29 I 1 Other - Specify
9 1 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 $ 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.) h
11. TOTAL COST OF IMPROVEMENT $ /ar 000
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 j
30 n Masonry (wall bearing) 40 Public or private company 48. Number of stories /
31 I/�I Wood frame 41 Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
321 1 Structural steel dimensions //5
33I Reinforced concrete H. TYPE OF WATER SUPPLY
34 I I Other - Specify 42 X Public or private company 50 Total land area, sq . ft. '/'
e
43 1 Private (well, cistern) K. NUMBER OF OFF - STREET ''`
PARKING SPACES
51. Enclosed
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 ><1 Gas Will there be central air 52. Outdoors
conditioning"'
36 L I Oil L. RESIDENTIAL BUILDINGS ONLY
37 Li Electricity 44 Ti Yes 45 53. Number of bedrooms
38 1_1 Coal
39 Li Other - Specify Will there be an elevator? Full
54. Number of
46 Li Yes 47 1,'x(1 No bathrooms /
7 r Partial...G..
Ire
r ..�
i 11 �^� -y
Y` DEPT. O BOLDING INSPECTIONS o (/7' `��C_ �
212 Main Street BUILDING Z 0‹
" _..,. > Northampton, MA 01060 PERMIT Q
15B - 36 VALIDATION
Garry Cousins DATE July 1, 98 1 8a[R 1 P §�'�tTlNPton 350
APPLICANT `� ADDRESS
(NO.) (STREET) ICONTR'S LICENSE)
PERMIT TO New Building One Family Dwelling NUMBER OF +1
(_I STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE) URA
AT (LOCATION) 10 Dimock Street DISTRICT
CT
(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 for the construction of a new single family INXXX dwelling
AREA OR 1135 sq. ft. 70 000.00 PERMIT 476.00
VOLUME ESTIMATED COST $ FEE $
(CUBIC /SQUARE FEET)
OWNER William Hartley
ADDRESS 39 Water St., Leeds, Mass. 01053XXXX BYILa' DE /� �,
WHITE - FILE COPY • GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY
P' INTi P