29-450 DEPT. FILE COPY
DEPARTMENT OF BUILDING INSPECTIONS
BUILDING z a
STREET PERMIT
ed 0944. /c0:67 T ION, MA. 01060
VALIDATION
29 — 50 DATE April 18, 19 79 PERMIT NO. 138
APPLICANT Norman Paulsen ADDRESS 48 Wildavod Lane, So. Hadley
(N0.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO New rpe3donne ( 1 ) STORY ReajdeTIOe DWELLING UNITS 1
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ZONING
AT"(LOCATION) Crestview Drive D STR CT URA
(NO.) (STREET)
a BETWEEN Off Brookwood Drive AND
0 (CROSS STREET) (CROSS STREET)
a
LOT
a.m SUBDIVISION Brookwood LOT 72 BLOCK SIZE
V BU)LD �IS TO BE 2k FT. WIDE BY 42
O FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
ip
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
X (TYPE)
CY
IL REMARKS: One—family residence See plans for Lot # 45
AREA OR PERMIT
VOLUME lOOo ESTIMATED COST 22,000 FEE •. CI
(CUBIC/SQUARE FEET) ��
OWNER Nnr�man Paul aen if'
ADDRESS 48 W11th'ood LRrte� So- Hadley BY -44 A74.
'� .�.-�
(Affidavit on reverse side of application to be completed by authorized agent of o er)
I hereby certify that the proposed work is authorized by the owner of record
and I have been authorized by the owner to make this application as his
authorized agent.
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19 .
7- V5
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 �,1� PLAN EXAMINATION AND
f Y. BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: I, II, III, IV, and IX. o
k''I• AT (LOCATION) -[ter �i ZONING _ ,_
LOCATION (NOr) (STREET)
OF BETWEEN `'G[r4" /1.9„"___ AND
BUILDING (CROSS STREET) (CROSS STREET)
"� LOT
SUBDIVISION /
LOT � BLOCK SIZE
-- H
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
–I
1 ILI–New building Residential Nonresidential
2 I I Addition(If residential, enter number 12 I-1:1-Qne family 18 I Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 I I Two or more family – Enter 19 I Church, other religious
number of units– – – – --* 20 Industrial
3 I I Alteration (See 2 above)
14 I Transient hotel, motel, 21 Parking garage
4 I Repair, replacement or dormitory – Enter number
5 I I Wrecking (If multifamily residential, of units – -.0- 22 I Service station, repair garage
enter number of units in building in 15 I I Garage 23 1 Hospital, institutional
Part D, 13)
16 1 Carport 24 I Office, bank, professional
6I Moving (relocation)
17 I Other – Specify 25 Public utility
7I 1 Foundation only
26 I School, library, other educational
B. OWNERSHIP 27 I Stores, mercantile
8 I I Private (individual, corporation, 28 Tanks, towers
nonprofit institution, etc.) 29 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 $ 7V-t2 school, secondary school, college, parochial school, parking garage for,
/K–' 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 Gl J
b. Plumbing / 501'3
c. Heating, air conditioning / 5–cT6
d. Other (elevator, etc.)
11. TOTAL COST OF IMPROVEMENT $ 0QC?
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Ports 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_I Masonry (wall bearing) 40 I— ublic or private company 48. Number of stories
31 IL.1N 49. Total square feet of floor area,
d frame 41 I I Private (septic tank, etc.) all floors, based on exterior
32 Structural steel
I dimensions / r[Cj�
(7"�
33 I Reinforced concrete H. TYPE OF WATER SUPPLY
34 I I Other – Specify 42 Public or private company 50. Total land area, sq. ft. /U 'f
43 I I Private (well, cistern) K. NUMBER OF OFF-STREET f V
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed
35 I I Gas Will there be central air 52. Outdoors l.../-
36 I O.L conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 1 1 Electricity 44 I Yes 45 I No 53. Number of bedrooms
3
38 1 I Coal
39 I j Other– Specify Will there be an elevator? 1 Full
f
54. Number of
46 I I Yes 47 I1No bathrooms Partial
NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
414
Lessee
/a C9f075.
2. ► t Builder's
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 applicant Address Application date
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 By
y pp Obtained y
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
7 7 Use Group
Permit issued ii(“4.1
Building
/ Fire Grading
Permit Fee $ 66 . d
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE