29-451 (2) DEPT. FILE COPY
z
.OF BUILDING INSPECTIONS BUILDING 31-
212 Main Street
el
PERMIT
VALIDATION
Northampton,Mass.01060 29-451
DATE September 11 , is 78 PERMIT NO. 505
APPLICANT Norman G. P9171 aP.n ADDRESS 48 Wi ldwnnci Lske, So_ Haul ey
(NO.) (STREET) (CONTR'S LICENSE)
OF
PERMIT TO New Residence ( 1 ) STORY RPq derIC?P D EL
i LLING UNITS 1
(TYPE OF IMPROVEMENT) NO (PROPOSED USE)
ZONING
AT (LOCATION) CY'eatviAW T'ivA I
DISTR
DISTRCT URA
(NO.) (STREET)
ot BETWEEN Off Brookwood Drive AND
.0 (CROSS STREET) (CROSS STREET)
a
m SUBDIVISION LOT 71 BLOCK s LOT Inn X 109
4 L-shape
p BUILDING IS TO BE 29 FT. WIDE BY 38 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
a
0
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
E
tt (TYPE)
° REMARKS: Corustruct L-shape residence See Plans for Lot #465 Lot #46
AREA OR
VOLUME 983 ESTIMATED COST $ 31 ,700 FEEMIT $ 96.00
(CUBIC/SQUARE FEET)
OWNER TT(IrTRsT) G. Pa111 RP_rl
ADDRESS Wildwood Lake, So. Hadley, Ma. BUILD c/�T. f • ■ :
(Affidavit on reverse side of application to be completed by authorized agent of owner)
.,11;
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,, _:r
authorized agent.
SIGNATURE
NATURE 'OP` AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19
I
4.
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET - I -- h ;/ APPLICATION FOR
NORTHAMPTON, MA. 01060 PLAN EXAMINATION AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: I, II, III, IV, and IX. 0
ZONING '�I• AT (LOCATION) Pj� h7VtL1I1 1)µ)J2— DSTRCTL/l\
LOCATION (NO.) (STREET)
OF BETWEEN 617 7Ck.L )(icL B tA _t V AND
BUILDING (CROSS EET) (CROSS STREET)
SUBDIVISION LOT 7V BLOCK L
SIZOT yy//�E /VG X IOC
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D -1
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use Im
m
-I
1 New building Resid tial Nonresidential
2 I I Addition(If residential, enter number 1217 One family r 18 j Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 I Two or more family — Enter 19 Church, other religious
number of units— — — — —0. 20 Industrial
3 I Alteration (See 2 above) 14 I I Transient hotel, motel,
21 I 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 I Garage • 23 Hospital, institutional
Part D, 13)
16 I I Carport 24 Office, bank, professional
6 I I Moving (relocation)
17 I Other — Specify 25 Public utility
7 I I Foundation only _ 26 School, library, other educational
B. OWNERSHIP ,_`•`! iX "i C 27 Stores, mercantile
8 (/Private (individual, corporation, f. 28 Tanks, towers
nonprofit institution, etc.) ._,...L/ , ,-7,:et. 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 $ 1-80V0 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 /cC
b. Plumbing /f/,G°
c. Heating, air conditioning "I CC
d. Other(elevator, etc.) cj)1 O
11. TOTAL COST OF IMPROVEMENT $
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings Ind 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 Lasonry (wall bearing) 40 rViPublic or private company
48. Number of stories
31 r7 Wood 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 91;4
33 I I Reinforced concrete H. TYPE OF WATER SUPPLY
34 I 1 Other — Specify 42 Public or private company
50. Total land area, sq. ft. I6ZOO
43 I I Private (well, cistern) K. NUMBER OF OFF-STREET )
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed
35 (,Gas Will there be central air 52. Outdoors /
36 I `'l OiI conditioning?
_/ L. RESIDENTIAL BUILDINGS ONLY
37 1 Electricity 44 Yes 45 Vf No 53. Number of bedrooms
38 I I Cool
39 I I Other — Specify Will there be an elevator? 1 Full f
54. Number of
46 I I Yes 47 1YNo bathrooms
Partial
NOTES and Data — (For department use)
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. . . ENTIFICATION – To be completed by all applicants
Name Mailing address 1-pNumber,, street, city,,and State ZIP code —
Tel. No.
I.
Owner or N"NO VL t :1 ILCi I€J � L�✓�Al r�s� --/�LL_ta.- '-/�1/e ?`ZJ X1 �L'I' `St �J/e7-6 ►S 4/6 P
Lessee
Bui lder's
2. ---V-me, a-S. CY 7fi14 -- ----_- 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
i'1-7,---,"3 Li t Cam,-,( " r d ,j, -A.--z; Ali `iCi (ye ...Ael LIZ o aiel/i gait, 97.P
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD – For office use
Plans Review Required Check Plan Review Date PI By Date Plans By Notes
Fee Starte Approved
BUILDING $ • •
PLUMBING
MECHANICAL
ELECTRICAL $
for
OTHER
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Permit or Approval Check Obtained Number By: � Permit or Approval Check Obtained Number By
BOILER PLUMBING
CURB OR SIDEWALK CUT AI ROOFING
ELEVATOR SEWER
ELECTRICAL 4.* SIGN OR BILLBOARD
FURNACE STREET GRADES
GRADING USE F PUB.IC AREAS
OIL BURNER WRING
OTHER i" OTHER
•
VII. VALIDATION 'P
Building FOR DEPARTMENT USE ONLY
Permit number d !� •
Building . # Use Group
:i -2—
Permit issued ,, 7 19/'_.{`
Building _ Fire Grading
Permit Fee $ 7( ((f
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile
.
Plan Review Fee -:
T E