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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 JEt2t:f x �'� C��- W 00 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Required Check Plan Review Date P y Ions B Date Plans By Notes Fee Started Approved BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL $ OTHER $ VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Date te Permit or Approval Check Obtained Number By Permit or Approval Check ObtaaTned 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 Bui(ding. Use Group Permit issued 1 19 Building O Fire Grading Permit Fee $ Live Loading Certificate of Occupancy $ Occupancy Load Ap o e by: Drain Tile $ i' J Plan Review Fee $ TITLE CITY OF NORTHAMPTON ��,�,o o MASSACHUSETTS $ OFFICE of the INSPECTOR of BUILDINGS ,U, 10 Page r95--f Plot 31� APPLICATION FOR INSPECTOR ZONING PERMIT AND BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. � O ZONING I• AT (LOCATION) ���"'��� / `N DISTRICT LOCATION (NO.) (STREET) OF BETWEEN 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(If 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 C❑ Industrial 3 Iteration (See 2 above) 14 Transient hotel, motel, ❑ 21 ❑ Parking garage 4 Repair, replacement or dormitory — Enter number [-:] 22 ❑ Service station, repair garage 5 Wrecking (1/multifamily residential, of units ——————— — enter number of units in building in 15 ❑ Garage 23❑ Hospital, institutional Part D, 13) 16 ❑ Carport 24❑ Office, bank, professional 6 C, Moving (relocation) 17 Other — SpeciJy D r::C-4K 25❑ Public utility 7 ❑ Foundation only y� 26❑ School, library, other educational B. OWNERSHIP cox-A J 27❑ Stores, mercantile 8 ®Privote (individual, corporation, 28 ❑ Tanks, towers If ., nonprofit institution etc.)) 29❑ Other — SpeciJy 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 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 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 L❑ 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 51. Enclosed ....................... F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 35 ❑ Gas Will there be central air 52. Outdoors........................ 36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37 Electricity 44 ❑ Yes 45 7] No 53. Number of bedrooms.............. 38 ❑ Coal 39 Other — Specify Will there be an elevator? Full.......... 54. Number of 46 P Yes 47 ❑ No bathrooms Partial........ Department of Build�J#AOJ-nspections 212 Main Street Northampton, mass. 01060 BUILDING '° ���PERMI T °0. /0 � 29 - 376 VALIDATION DATE July 18, t9 84 PERMIT NO. 311 APPLICANT James Bousquet ADDRESS.—= F o-I renc'e Road Owner (NO.) (STREET) (CONTR'S LICENSE) OF PERMIT TO Repair/Replacemen _) STORY Pool Deck DWELLRING UNITS _ (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) 235 MORN% Florence Road ZONING I7RE1 AT (LOCATION) DISTRICT (N0.) ISTREET) 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 to replace deck for pool VOLUME ESTIMATED COST $ 250 FEkMIT 00 (CUBIC/SQUARE FEET) OWNER Same as applicant Same B ADDRESS B a2wld� WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY ■ PINK - ASSESSORS COPY