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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name '^ Mailing address — Number, stmt, city, and State ZIP code Tel. zNo,
Owner or i '1 L11 LJC : �� U I ` /� �jbc�'Jt2
6 6�
Lessee nn
Builder'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.
$ignoture o 4cont Address Application d to
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans
Fee Started y Approved By Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number B Permit Approval Check Date
By or umber B
Obtained pp Number 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
Use Group
e-)
Permit issued -��l%' T 19 (J �7
Building Fire Grading
Permit Fee $
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
JV T
Page Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. C)
ZONING
(• AT (LOCATION) ""'� U ) U (STREET) DISTRICT
LOCATION N0')
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
M
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use rn
1 F�rNew building Residentia. Nonresidential
2 Addition(If residential, enter number 12 ne family 18 E:] Amusement, recreational
of net) housing units added, if any,
in Part D, 13) 13 � Two or more family - Enter 19 � Church, other religious
number of units- - - - -)w 20 Industrial
3 Alteration (See 2 above) 14 Transient hotel, motel,
21 Parking garage
4 Repair, replacement or dormitory - Enter number Wrecking (If multifamily residential,
22 L� Service station, repair garage
5 of units ------- - -�
enter number of units in building in 15 1 Garage 23 �_ Hospital, institutional
Part D, 13) 16 Carport
24 F] Office, bank, professional
n
6 Moving (relocation) 25 C� Public utility
17 �] Other - Specify
7 Foundation only 26 School, library, other educational
B. OWNERSHIP 27 L Stores, mercantile
28 n Tanks, towers
8 �Private (individual, corporation,
nonprofit institution, etc.) 29 C Other - Specify _
9 n 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.
'I'o 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 $
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
48. Number of stories...............
30 D"Masonry (wall bearing) 40 Public or private company
��( 41 r� Private (septic tank, etc.) 49. Total square feet of floor ores,
31 Wood Frame p all floors, based on exterior
32 Structural steel dimensions .....................
33 Reinforced concrete H. TYPE OF WATER SUPPLY
34 n Other - Specify 42 Public or private company
SC. Total land ores, sq. fT. ...........
43 i__I Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 'D Gas Will there be central air i 52. Outdoors........................
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 —] Yes 45 No 53. Number of bedrooms..............
387 Coal
39 'i Other - .Specify Will there be an elevatoro Full..........
54. Number of
bathrooms
46 �� Yes 47 No Partial........
n _ n, .Y _,P,w -�. _,.. .�__ ,-� - - - _ - - -
�'�
a r{�
DEPT. OF BUILDING INSPECTIONS BUILDING Z° `
212 Main Street 0<
Northampton, MA 01060 PERMIT <a
VALIDATION
DATE ( s- = 19 PERMIT NO.-
i
APPLICANT ADDRESS
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO - ) (_) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 0 STR CT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE y'r FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: ,,_: � , of a 7'i'o
AREA OR , n r, PERMIT (,
VOLUME ESTIMATED COST $ �! tr�l�n'M) FEE $
oa �
(CUBIC/SQUARE FEET)
OWNER ' `�`�` raw ►L �n...
BUILD
ADDRESS BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY Piprs'P
DEPT. OF BUILDING INSPECTIONS BUILDING z_
! 212 Main Street O<
Northampton, MA 01060 PERMIT <a
29 , 480 VALIDATION
DATE get 19 PERMIT NO.
APPLICANT Joanne Sanborn • ADDRESS 89 Bur it Road Owner
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO New Building (-I STORY Storage Shed DWELLING UNITS
(TYPE OF IMPROVEMENT) N0. (PROPOSED USE)
589 Burts Pit Road ZONING SR
AT (LOCATION) DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE in FT. WIDE BY 12 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: permit for the construction of a storage shed
VOLUME 120 Cft_ ft._ ESTIMATED COST $ 1a 200.00 PERMIT $ 10.00
(CUBIC/SQUARE FEET)
OWNER cAmp aC Applirant Ul t�t,/r ��
ADDRESS Same as Apn11rAL3V I C BY t y
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY PINK - ASSESSORS COPY p