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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. Signat e f OF lic n Address / Application date 00 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Required Check Plan Review Date Plans By Date Plans By Notes Fee Started Approved BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL $ OTHER $ VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approva I Check Obia Date Number By Permit or Approval Check Obtta t ed Number By BOILER PLUMBING CURB OR SIDEWALK CUT ROOFING ELEVATOR SEWER ELECTRICAL SIGNOR BILLBOARD FURNACE STREET GRADES GRADING USE OF PUBLIC AREAS OIL BURNER WRECKING OTHER OTHER VII. VALIDATION �/ Building ` CIS FOR DEPARTMENT USE ONLY Permit number J Building /� — use Group Permit issued 19 Building Fire Grading Permit Fee $ �- ` Live Loading Certificate of Occupancy $ Occupancy Load Approved 6y: Drain Tile Plan Review Fee $ TITLE CITY OF NORTHAMPTON �• .� MASSACHUSETTS s OFFICE of t eINSPECTOR of BUILDINGS 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. O /O� d ZONING I• AT (LOCATION) ! t .�CaD ' DISTRICT LOCATION (NO.) (STREET) OF BETWEEN_ /�/� � AND J!J&At ✓�C�L BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE V1 II. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D __q A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m m 1 ❑ New building Residential Nonresidential 2 ❑ Addition(IJ residential, enter number 12 ❑ One family 18 ❑ Amusement, recreational of housing units added, if any, 13 ❑ Two or more family — Enter 19 ❑ Church, other religious i t D, 13) number of units— — — — 3� Part Alteration (See 2 above) 20 ❑ Industrial 14 ❑ Transient hotel, motel, 21 �_ Parking garage 4 Repair, replacement or dormitory — Enter number 5 ❑ Wrecking (II multifamily residential, of units ——————— — --f 22 ❑ Service station, repair garage enter number of units in building in 15 ❑ Garage 23 Hospital, institutional Part D, 13) ❑ 16 Carport 24 Office, bank, professional 6 ❑ Moving (relocation) � .[.(L Public utilit y 17 Other — SpeciJy 25 ❑ 7 ❑ Foundation only 26 ❑ School, library, other educational B. OWNERSHIP Aa,ttr`I �(ob(fY.��I(� frj� 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 — 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 1$ 10, 000 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 51. Enclosed ....................... F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 35 ❑ Gas OW Will there be central air 52. Outdoors........................ 36 ❑ oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37 Electricity 44 ❑ Yes 45 d No 53. Number of bedrooms.............. 38 ❑ Coal 39 ❑ Other — .Specify Will there be an elevator? Full.......... 54. Number of 46 ❑ Yes 47 ,�� No bathrooms Partial........ DiP*ft BUILDING INSPECTIONS BUILDING z0 + 212 Main Street Oa Northampton, MA 01060 PERMIT 29 - 167 VALIDATION DATE June 3 .g y 86 285 APPLICANT Stramese Construction ADDRESS b1Tii SPt $'�I N0 MUTUUT=16926 INO.) (STREET) (C ONTR'S LICENSEI Alteration Deck & Family Rm. Conveirwimk of PERMIT TO (_) STORY DWELLING UNITS (TYPE OF IMPROVEMENTI NO. (PROPOSED USE) 106 Brierwood Drive ZONING LIKA AT (LOCATION) DISTRICT (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) permit is for a deck and family room conversion REMagKS: AREA OR 101000-00 PERMIT s 40.00 r VOLUME ESTIMATED COST �P _ FEE (CUBIC/SQUARE FEET) OWNER Byram Shannon BUILD AOORESS106 Brierwood Dr. BY WHITE - FILE COPY ■ GREEN - FIELD COPY a CANARY - APPLICANT COPY • PINK - SSESSORS COPY pjNT 'p I;