29-367 (2) LIN\
(EitV of Xort4ampton
1z
DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street * Municipal Building
Northampton, Mass. 01060
SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION
Page p Plot367 Zone U Permit Number
Location
Owner or Lessee
r (Tele. No.)
Contracto
(License Number)
Address
RESIDENTIAL NON-RESIDENTIAL
One Family Home Business
Two or More Number of Units Other (Specify)
Floors in Bldg.
Type of Appliance:
New Wood Burning
Used coal
Labeled Combination
Date of purchase Furnace
7— Fireplace Insert
Model or Type of Appliance
Manufacturer
Purchased From
(Name of Firm)
(Address)
Cost - Construction & Appliance:
Chimney New ✓ Metal Bestos
Vved,t*,T77•16- Interior Chimney
Separate Flue Exterior Chimney
Other appliance attached to flue
Masonary/lined
Unlined
Notes & Data:
Signature of Applicant:
Building Inspector Approval:
Date:
ZONING •
DISTRICT
`.
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
For Applicant Use
IX. SITE OR PLOT
■.......
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NOTES and Data — (For department use)
lip3
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Ole)
or ( �<yOle) <03 o,'Y
Lessee
But[der's
1.
License No.
Contractor V^ -
e'+t9''
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
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
9 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Obtained Number By Permit or Approval Check Obtained
BOILER 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 ( 19
Building Fire Grading
Permit Fee
Live Loading
Certificate of Occupancy $ Occupancy Load
ov by: t
Drain Tile $ f
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�• �+ MASSACHUSETTS
d OFFICE of the INSPECTOR of BUILDINGS
Page 42 Plot 34'/ APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, 1V, and 1X. O
ZON ING�/.//leA
• AT (LOCATION) C.�•^°'�- "' �°""'7�°'t.•�'°�� _ DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) ICROSS STREET)
LOT
`*0 SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D --I
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
f 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
3 Alteration (See 2 above)
`number of units— — — — 20 Industrial� ❑
140 Transient hotel, motel, 21 parking garage
4 Repair, replacement or dormitory — Enter number
"" 22 Service station, repair garage
5.❑, Wrecking (11 multifamily residential, of units ------- — -�. ❑ P 9 9
enter number of units in building in 15 El Garage 23 Hospital, institutional
Part D, 13) 16 Carport 24 Office, bank, professional
6 Moving (relocation) P
17 Other - Specify 25 Public utility
7❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 Private (individual, corporation,
28 Tanks, towers
nonprofit institution, etc.) 29 Other — Specify
9 Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential — Descrikj- 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 t
a• Electrical... ................ sb
b. Plumbing ............I........ j�
c. Heating, air conditioning...:.:... `
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT Is cbd
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. ft. ...........
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 the a be central air 52. Outdoors........................
36 ❑ Oil condition g?
37 Electricity 44 Yes 45 j No L. RESIDENTIAL BUILDINGS ONLY
❑ 53, Number of bedrooms....t7........
38 Coal
39 n Other — Specify Will ther be an evator? Full.
54. Number of ......
46 Yes No bathrooms
Partial........
�.rt�,
.�_ .. .
e�y �'��►
Department of Building Inspections
212 Main SkA*aw• i w * -.0 BUILDING zp
Northampton, Mass. 01060
PERMIT
29 - 369
VALIDATION
DATE April 19, `19 83 PERMIT No. 164
APPLICANT Dennis Matthew& ADDRESS 61 Austin Circle
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO (,) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION)
61 Austin Circle DOS IR 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: Add wood stove and metal chiemnev and renovate basement phitions and new bath
AREA OR ESTIMATED COST $ 2,500.00 FEEMIT $a 10.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER Dennis Matthews BUILD
ADDRESS _,. 61 Austin C1 rrl P - BY
WHITE - FILE COPY . GREEN ^ FIELD COPY ■ CANARY - APPLICANT COPY PINK - AS ESSORS COPY