23D-006 DEPT. FILE COPY
RTMENT OF BUILDING INSPECTIONS D°
STREET BUILDING
NORTHAMPTON, MA. 01060 PERMIT
VALIDATION
23D — 6
DATE June 25, 19 79 PERMIT NO. 293
APPLICANT Ri chard Cit. G117OW9ki ADDRESS 64 Ncrnni:lick
(N0.) (STREET) (CONTR'S LICENSE)
PERMIT TO Add chimney ( 2 ) STORY For wood—burning stove NUMBER OF
DWELLING UNITS 1
�� (TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOc )3 YY ON) 64 NOT10tuck ZONING
DISTRICT TTRR
(NO.) (STREET)
a BETWEEN Flrlkley AND New
o0 i (CROSS STREET) (CROSS STREET)
LOT
m SUBDIVISION LOT BLOCK SIZE
a
V
O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
01
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
X
re
(TYPE)
o
IL REMARKS: Instal la.f:ion Of metal bestoe chimney' for -Se with Wood-burning stove.
C+7,4cee.c..)--";e4now":0-.48'4'4.'4 (.41diej ce....
AREA OR 04 1 oil?
VOLUME ESTIMATED COST $ 350.00 FEE MIT �
(CUBIC/SQUARE FEET)
OWNER Richard G. Gutowski
BYIL `��^ � J /
ADDRESS 64 Nnnnttank St. , Fl nrPnee, M . BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)
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 .
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 r, -.3'12 -- .6 PLAN EXAMINATION AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, II, III, IV, and IX. 0
I. AT (LOCATION) A/0,i°ik.t `/ J 7Liee t Fl o,e", -c. ZONING /� �
DISTRICT Z('�
LOCATION (NO.) v/ (STREET) j
OF BETWEEN iiiii (ey -C AND it/e,,, 5 t-
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
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
in
1 1 1 New building Residential Nonresidential
2 I I Addition(If residential, enter number 12 LprOne family 18 Amusement, recreational
of new housing units added, if any, 13 Two or more family — Enter 19 Church, other religious
in Part D, 13) � � Y gi
number of units— — — — -). 20 Industrial
3 Alteration (See 2 above) 14 1 Transient hotel, motel,
21 Parking garage
4 I I Repair, replacement or dormitory — Enter number
5 I I Wrecking (If multifamily residential, of units — 22 Service station, repair garage
enter number of units in building in 15 Garage 23 Hospital, institutional
Part D, 13)
16 I Carport 24 Office, bank, professional
6I Moving (relocation)
17 I I Other — Specify 25 Public utility
7 I I Foundation only � 26 School, library, other educational
■B. OWNERSHIP i i//_ 27 Stores, mercantile
8 Private (individual, corporation, 28 Tanks, towers
nonprofit institution, etc.) 29 Other — Specify
9 I I Public (Federal, State, or
local government)
4.4y
C. COST (Omit cents) Nonresidential — escribe in detail proposed use of buildings, e.g., food
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement $ 350 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 $ Y-1---Z)
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 LA Masonry (wall bearing) 40 PI Public or private company 48. Number of stories
31 Wood frame 41 I I Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 I Structural steel dimensions
33 I I Reinforced concrete H. TYPE OF WATER SUPPLY
34 I I Other — Specify 42 I I Public or private company 50. Total land area, sq. ft.
43 n Private(well, cistern) K. NUMBER OF OFF-STREET
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
36 Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 I Electricity 44 I I Yes 45 I I No 53. Number of bedrooms
381 Coal
39 I Other — Specify Will there be an elevator? Full
54. Number of
46 I I Yes 47 I I No bathrooms
Partial
.ems--
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.
1.
Owner or
RIC/4, .,1 6. 6-4 d /� ���� �� 5r. F<�. r /74 o��1 a 5T�,-i d
Lessee
Bui Ider's
2. 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
er 6 y e
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 FOR DEPARTMENT USE ONLY
Permit number
Building Use Group
Permit issued � n0i p°( ' 19
Building Fire Grading
Permit Fee $ /U. c'(7 Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
/. TIT