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NOTES and Data — (For deportment use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or {N
I Cis&S
Lessee 0106 v
h E ►YI[L
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.
lit J.�L I
$ig lu=fl nt Address Application date
lil-.
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans B Notes
Fee Started Approved y
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 B
Obtained 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 Use Group
Permit issued _'�� � ► 19
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
�b
t Page Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. 0
ZONING t
I• AT (LOCATION)
7 1A e..d's tJ., t(" DISTRICT b
LOCATION 'JA_ (NO.) (STREET) wi\
OF BETWEEN S,�C ( rP_(C AND
;BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
H
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
m
1 New building Residential Nonresidential
2 Addition(1/residential, enter number 12M One family 18 ❑ Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 ❑ Two or more family - Enter 19 n Church, other religious
number of units- - - - --> 20❑ Industrial
3 ❑ Alteration (See 2 above) 14 Transient hotel, motel,
_ ❑ 21 �� Parking garage 4•-
4 ❑ Repair, replacement or dormitory - Enter number
22 Service station, repair garage
5 � Wrecking (If multifamily residential, of units ------- - --�
❑
enter number of units in building in 15 ❑ Garage 23 Hospital, institutional
Part D, 13) 16 F-] Carport 24 Office, bank, professional
6 Moving (relocation)
17[__1 Other - Specify 25 ❑ Public utility
7 Foundation only 26 School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 KPrivote (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 Other Specify
9 ❑ 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................ C;3,;_ 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 ...................... S 11S.) U dddLLL���Sc�
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 F-1 Masonry (wall bearing) 40'S Public or private company : f... /
31 Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square feet floor area,
all floors, based on exterior
32 Structural steel dimensions ..................... 91! 6
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
q Public or private company 50. Total land area, sq. ft. ...........
42
34 � Other - Speci/y ,® p
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed ......................
F. PRINCIPAL TYPE OF HEATING FUEL 1. TYPE OF MECHANICAL
35 0 Gas Will there be central air 52. Outdoors........................
cnditioning?
36 ED oil o L. RESIDENTIAL BUILDIN��� �S fJ Y
37 Electricity 44 Yes 45 No 53. Number of bedrooms.t�F:C�..
38 Coal
39 Other - Specify Will there be an elevator? 54. Number of Full..........
--
46 Yes 47,F!�] No bathrooms Partial.,.....
F BUILDING INSPECTIONS BUILDING z°
! 212 Main Street Ia,- l a0 - cX--_)
Northampton, MA 01060 PERMIT
29 - 294 VALIDATION
DATE September 2, 19 86 PERMIT No. 507
APPLICANT Donald & Susan Shiels ADDRESS PencasaT Dr. , Florence 9wners
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO Addition (_) STORY One Family dwelling D WELL
One OF
UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING AT (LOCATION) 37 Pencasal Drive D STR CT URA
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS; permit for the addition of a second story to be used for single family dwelling
existing will be 4 bedrooms and a bath
AREA OR VOLUME 750 sq. ft. ESTIMATED COST $ 27+500.00 FEEM)T .� 150.00
(CUBIC/SQUARE FEET)
OWNER Same as Applicant
BUIL
ADDRESS ._ Same as Applicant's BY � 1 0 1��_
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY ^ APPLICANT COPY • PINK - AS ESSORS COPY 2p