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IDENTIFICATION — To be completed by all applicants ` Name Mailing address — Number, street, city, and State ZIP code Tel. No. Owner or ��6- -�,-. ` " �,.I'i11�.." ' `./ �•' „l t j �/ l �i ��� ��I�� / p -• f�C �!; Lessee Builder's C 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. Signature of applicant 1 Address Application date D0 NOT WRITE B E 6 W TvHIS 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 $ VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approva I Check Date Number B Permit or Approval Check Number B I Ch Date umer Obtained Y pp _ 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. / 1 ' �' Use Group Permit issued 1q Building - g Fire Grading $ Permit Fee Live Loading Certificate of Occupancy $ Occupancy Load App e y: Drain Tile Plan Review Fee $ TITLE Q3 CITY OF NORTHAMPTON B+ ~ MASSACHUSETTS e OFFICE of the INSPECTOR of BUILDINGS Page 0t Plot e_10 APPLICATION FOR ZONING PERMIT AND INSPECTOR BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: 1, 11, III, IV, and IX. Q ZONING I• AT (LOCATION) �,J .��,f ' f ' 1� DISTRICT LOCATION (NO.) (STREET) OF BETWEEN -AND BUILDING (CROSS STREET) CROSS STREET) LOT SUBDIVISION LOT_ BLOCK SIZE V1 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 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 ❑ 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 ––––––-- – -i 22 Service station, repair garage enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional Part D, 13) 24 ❑ Office, bank, professional 6 ❑ Moving (relocation) 16 ❑ Carport / r' 17 Other – Specify p1 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 ( it cents)ot Nonresidential – Describe in detoil proposed use of buildings, e.g., food processing plant, machine shop, laundry building at hospital, elementary 10. Cost of improvement,,,,,,,,,,,••.. r 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 than ad, enter proposed use. in the above cost // a. Electrical..................... C'l L'1 U b. Plumbing ..................... fi c. Heating, air conditioning.......... d. Other(elevator, etc.)............. 11. TOTAL COST OF IMPROVEMENT $ JJJ JJJJJJ"'''' III. SELECTED CHARACTERISTICS OF BUIfLDING — For new buildings and additions, complete Parts E — Li 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 [,—Kl 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 ..................... 2 .r 33❑ Reinforced concrete H. TYPE OF WATER SUPPLY 34 ❑ Other – Specify 42 [K] Public or private company 50. Total land area, sq. ft. ........... L r ( S eci 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 , No �_ . 53. Number of bedrooms.............. 38 ❑ Coal 39 Other – Specify Will there be an elevator? Full.......... � 54. Number of 46 ❑ Yes 47 L�j No bathrooms Partial........ ..,. .: .Ty.�-,� aa°�".. ,,a.z-.Wang ?.r.E g i .� :�., t ��� lepartment of Building Inspections ;12 Fain Street fortha ton, MasS':"14601060 BUILDING o° PERMIT 29 -SA08 VALIDATION DATE October 24, 19 83 PERMIT NO. 620 APPLICANT Albert J. St. Onge ADDRESS 89 Sandy Hill Road Owner (NO.) (STREET) (CONTR'S LICENSE) Addition Fau it Y Rooim NUMBER OF PERMIT TO I_) STORY DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) AT (LOCATION) 89 Sandy Hilt Road ZONING DIST'R ICT ITRA (N0.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE 18 22 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 fa. ly room; on. the back of existing house AREA OR 396 s . ft. $ 500.00 PERMIT 28.00 VOLUME ESTIMATED COST $ F FE (CUBIC/SQUARE FEET) OWNER Albert J. St. Onge ADDRESS $ any H1 1 oa , orence BY WHITE - FILE COPY . GREEN - FIELD COPY a CANARY - APPLICANT COPY • PINK - ASSESSORS COPY