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DISTRICT
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NOTES and Data — (For department use)
tea.
A%-04.
IV. IDENTIFICATION To be completed by all applicants
Name Mailing address Number, street, city, and State ZIP code Tel. No.
1.
Owner or
Lessee cF
Builder's -411
Lice
2. nse No. IE�z S
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
e this application as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
gnatu're of app]_Zn Address Application date�fy
V/ ?
OD NOT W R I T E BELOW T H I S L I N E
V. PLAN REVIEW RECORD — For office use
Plan Review Date Plans Date Plans
Plans Review Required Check Fe Started By Approved By Notes
BUILDING $
PLUMBING $
MECHANICAL 1$
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check 0 Date o By Permit or Approval Check ate
btoined Number bDtained 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
V11. VALIDATION
Building i FOR DEPARTMENT USE ONLY
Permit number QA
Building Use Group
Permit issued 19 /J 7—
Building Fire Grading
Permit Fee $ & �.z Live Loading
Certificate of Occupancy $ Occupancy Load
Approve
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
g* MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
ao
Page Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
I. �� �c t2_ i„-: a ZONING I
AT (LOCATION) c'— ( �'- 4L/ �A DISTRICT`)
LOCATION (NO.) (STREETI
OF BETWEEN �r.�._ c` :� (,-,r� ..;y— AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
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(!/ residential, enter number 12 One family 18 ❑ Amusement, recreational
of new bousing units added, if any.
in Part D, 13) 13 ❑ Two or more family — Enter 19 �❑ Church, other religious
number of units— — — — 20 ❑ Industrial
3 ❑ Alteration (See 2 above) 14 Transient hotel, motel,
21 Parking garage
4 Repair, replacement or dormitory — Enter number
5 ❑ 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) Office, bank,
P
24 Oi ,
16 ❑ Carport I_
6 ❑ Moving (relocation) 25 ❑ Public utility
77 ❑� Other — Specify
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP 27 �❑ Stores, mercantile
8 L❑ Private (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,,,, ,,,,,,,,,, '/ %', — 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
b j S
a, Electrical.....................
b. Plumbing ....................
r
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
30❑ Masonry (wall bearing) 40 ❑ Public or private company 48. Number of stories................
31 ❑-Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 ❑ Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other — Specify 42 ❑ Public or private company 50. Total land area, sq. 1t. ..........
43 ❑ 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 ❑ Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 CLI Electricity 44 Yes 45 ' No
-- 53. Number of bedrooms..............
38 ❑ Coal
39 �❑ Other — Speci/y Will there be an elevator" Full..........
54. Number of
46 [ ] Yes 47 ❑ No bathrooms
Partial.......
DEPtINUILDING INSPECTIONS BUILDING �° �� ��
212 Main Street 0
Northampton, MA 01060 PERMIT <a
29 _ 322 VALIDATION
7 DATE April 9, 1987 t9 PERMIT NO. 174
APPLICANT Prospect BuildKKOXXX �
ADDRESS ospect St. , Eas ongmea oW 017699
(NO.1 (STREET) (CONTR'S LICENSE)
PERMIT TO Repair/Replacement ,_, STORY One Family NUMBER OF
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE) DWELLING UNITS
AT (LOCATION)
381 Acrebrook Drive Florence ZONING URA(N0.) (STREET) DISTRICT
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: Kermit for interior repairs caused by fire damage
AREA OR 5,400.00 PERMIT 10.00
VOLUME ESTIMATED COST $ FEE
(CUBIC/SQUARE FEET)
OWNER Frederick Becklo nn -
ADDRESS 381 Acrebrook Drive, Florence B" !'G t �"
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY p241P