11-007 (2) DEPARTMENT OF BUILDING INSPECTIONS DEPT. FILE COPY
212 MAIN STREET D° , / �' ,�
NORTI:AMPTON, MA. 01060 BUILDING <a � w r
11BD - 7 Code ##79 PERMIT VALIDATION
DATE November 2, 19 79 PERMIT NO. 636
APPLICANT Stanley Rothman ADDRESS 67 Coutry Way
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO Addition (_2_1 l' NUMBER OF STORY Wood-. ing stove DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ZONING
AT (LOCATION) 67 Country Way DIISTR CT RR
(NO. (STREET)
orn BETWEEN AND.
a (CROSS STREET) (CROSS STREET)
LOT
d m SUBDIVISION LOT BLOCK SIZE
a .
u BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
m
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
I (TYPE)
CC
u_ REMARKS: Tnsta11 wnnd_bin'ning stove in Pori sting chimney
A/ i 4475.--
r.°°"
AREA OR PERMIT
VOLUME ESTIMATED COST $ 180.00 FEE .$ 10000
(CUBIC/SQUARE FEET) //
OWNER Stanley Rothman BUI `.�-T /'
ADDRESS 67 Country Way, Northampton, Ma. BY : .i_ '
(#S;„ ..:W1't on re-/',.r-e. i...._ cT P p!icohcr: to b.: -c. ;p!nt.72+ by c7,11-11-:,C7 o J c.:,-.-.:1-0,- . e..if j
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
1O.
wner or , /�1
Lessee
•
Builder's
2. License No.
Contractor (�'/_ , . i � ,
3. '�{J
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 applicant Address Application date
C"&‘Al 12e44
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 Date
Permit or Approval Check Obtained 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 C-2 FOR DEPARTMENT USE ONLY
Permit number 4r�
Building Use Group
Permit issued C. 1977
Building Fire Grading
/0
Permit Fee $ Live Loading
Certificate of Occupancy Occupancy Load
Ap evAd by:
Drain Tile
Plan Review Fee -‘ NA.44.11-efAA-
TITLE
NOTES and Data — (For department use)
9 RD
CITY OF NORTHAMPTON 1/ -- 7
' OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 PLAN EXAMINATION AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, II, III, IV, and IX. 0
/�/ ZONING
I. AT (LOCATION) G 7 Y_ ZONNG
LOCATION (NO.) BEET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Vr
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 X Addition(If residential, enter number 12 I One family 18 I Amusement, recreational
of new housing units added, if any,
in 13 I I Two or more family — Enter 19 1 I Church, other religious
in Part D, 13) number of units— — — — -->
3 n Alteration (See 2 above) 20 Industrial
14 I I Transient hotel, motel, 21 Parking garage
4 I I Repair, replacement or dormitory — Enter number re
5 I Wrecking (If multifamily residential, of units — 22 I Service station, repair garage
enter number of units in building in 15 I Garage 23 Hospital, institutional
Part D, 13)
16 I Carport 24 I Office, bank, professional
6I I Moving (relocation)
17 I Other — Specify ` U 25 Public utility
7 I Foundation only
26 School, library, other educational
B. OWNERSHIP � 27 Stores, mercantile
28 I Tanks, towers
8 K Private (individual, corporation, Other — S eci
nonprofit institution, etc.) I p fy
9 I Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food
ti
/ processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement $ ( Q (J 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.)
11. TOTAL COST OF IMPROVEMENT $ /PO
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 L Masonry (wall bearing) 40 X Public or private company Number of stories
31 KWood frame 41 I I Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 I I Structural steel dimensions
33 I Reinforced concrete H. TYPE OF WATER SUPPLY
34 I I Other — Specify 42 x Public or private company 50. Total land area, sq. ft.
43 I 1 Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed
35 I 1 Gas Will there be central air 52. Outdoors
36I I Oil c•,•itioning? L. RESIDENTIAL BUILDINGS ONLY
37 ut Electricity 44 45 I No 53. Number of bedrooms
38I Cool
39 I I Other — Specify Will th- - be an elevator'_,,, Full
---,„ 54. Number of
• I I Yes 47 I I No bathrooms
Partial
g.