29-450 (3) DEPARTMENT OF BUILDING INSPECTIONS Z o DEP FIE COPY.. f q
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NORTHAMPTON, MA. 01060 B!V LIJ F�1 G Q a O, fr. E S-7
29 450 Code #79 PERMIT VALIDATION
DATE December 10, 19 79 PERMIT NO. 701
APPLICANT David Fesko ADDRESS 24 Crestview Drive
�+�,�„,
(NO.) (STREET) (CONTR'S LICENSE)OF
PERMIT TO Chimeny & stove (_) STORY For WOOF—burning stove DWELLING UNITS 1
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION), 24 Crestview Drive ZONING DISTRICT URA-
(No.) (STREET)
o. BETWEEN AND
m (CROSS STREET) (CROSS. STREET)
a
LOT
a
m SUBDIVISION LOT BLOCK SIZE
4
U
O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
•
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
X (TYPE)
C
� REMARKS: Tpata1l new metal bestos chimney and wood—burning stove
AREA OR
VOLUME ESTIMATED COST $ 500.00 FEE $ 10.00
(CUBIC/SQUARE FEET)
OWNER David Fesko --'
ADDRESS 211. erestv-(pw Urive, NI ton.
(Affidavit on reverse side of application to be completed by authorized agent of owner)
r
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 .
r
+Pr',miller CITY OF NORTHAMPTON o 71 1)
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. ����yy11,�(()� 0
I ZONING 4ei
AT (LOCATION) DISTRICT
LOCATION (NO.) (STREET)
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 -1
Po
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
m
--f
1 I I New building Residential Nonresidential
2 INI Addition(If residential, enter number
12. 1 One family 18 Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 I I Two or more family — Enter 19 Church, other religious
number of units— — — — --0- 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 Wrecking (If multifamily residential, of units — -0- 22 Service station, repair garage
enter number of units in building in 15 I Garage 23 Hospital, institutional
Part D, 13)
6 I I Moving (relocation) 16 I Carport 24 Office, bank, professional
•17 Other — Specify �q 25 Public utility
7 I I Foundation only '•`t ls�^'ri
40.44,,-.44,e-TAI /i' '" , 26 School, library, other educational
B. OWNERSHIP ,."LJ��/---' 27 Stores, mercantile
8 ii< 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 $ 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.) c�
11. TOTAL COST OF IMPROVEMENT $ J`J
III. SELECTED CHARACTERISTICS OF BUILDING - For new buildings and additions, mplete Parts E - L;
for wrecking, corn lete only Pa , for all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL .. DI SI S
30 L_] Masonry (wall bearing) 40 I Public or private tampon r f stori s
31 Wood frame 41 I Private (septic tank, ,) 448
49 to floors r et f fl or area,
all floors ba ed n exterior
32 I Structural steel d' sion
33 Reinforced concrete H. TYPE OF SU LY
50. of lark] area, sq. ft.
34 I I Other — Specify 42 I Publi r priv• c pony
4 III♦, Private (w I, cis ern) , 4 NU BER OF OFF-STREET
.4 / °/ I I PAR ING SPACES
F. PRINCIPAL TYPE OF HEATING FA" TYPE OF MEC • F'L 51. Enclosed
35 I Gas J Will th-e, be centr• • r 52. Outdoors
36 Oil conditi.^ .? .
� L. RESIDENTIAL BUILDINGS ONLY
37 I Electricity 1' es ° 45 I ' 0 53. Number of bedrooms
38 I Coal
...,/39 I I Other — Specify /IV� iII there be an elevator? 1 Full
54. Number of
46 I I Yes 47 No bathrooms
Partial
NOTES and Data — (For department use)
IDENTIFICATION — To be completed by all applicants
Naamm Mailing address — Number, street, city, and State ZIP code Tel. No.Azet .
Owner or
Lessee
Builder's
2. License No.
Contractor a.
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 fiapplicant Address Application date c7Aktfz__.
/ f �
r�r rurt`
,_„_,
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 $
i
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Obtain d Number By Permit or Approval Check RED ODate
R OT 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
Per(ding ,/�(W246� //,�f l Use Group
Permit issued / 197
Building // Fire Grading
Permit Fee $ C v
Live Loading
Certificate of Occupancy $
• cupancy Load
•p o• -d by:
Ze....fiz.,
Drain Tile $
`_„„ig ( /
Plan Review Fee $
TITLE