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t>��ES prd Datc
11 ml INN
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and .Stab° ZIP code Tel. No.
1.
Owner or
Lessee
Builder's
2. 06 5 �• 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 Address Application date
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Pions Review Re wired Check Plan Review Date Plans B Date Plans B Notes I
4 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obtained Number By Permit or Approval Check obtained 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
II. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building. Use Group
Permit issued �1 J� 19 <�
Building
Fire Grading
Permit Fee $_ ��.C�JC'
Live Loading
Certificate of Occupancy $ Occupancy Load
A ed by:
Drain Tile $
Plan Review Fee $
TITLE t
P
>r ,, •. CITY OF NORTHAMPTON
�+ •� MASSACHUSETTS
e OFFICE of the INSPECTOR of BUILDINGS
Page .�Q Plot /1r�
..,r g 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) •�/ je:je " '�'^�e DISTRICT
LOCATION N0.) _P (STREETI
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 -4
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
M
1 New building Residential Nonresidential
2 F__j Addition(If residential, enter number 12,KOne family 18 Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13F Two or more family — Enter 19 Church, other religious
number of units— — — — --yo. 20 Industrial
3 Alteration (See 2 above) 14 Transient hotel, motel,
21 Parking garage
4 Repair, replacement or dormitory — Enter number
of units ------- -- 22 Service station, repair garage
5 ❑ Wrecking (I/multifamily residential, —
enter number of units in building in 15 Garage 23 Hospital, institutional
Part D, 13) 16 Carport 24 D Office, bank, professional
6 Moving (relocation) Q
7 � Foundation only 17❑ Other — Specify . 25 0 Public utility
(� r ,-/ v n 26 School, library, other educational
B. OWNERSHIP ` ^� � rte' 27 Stores, mercantile
8 Private (individual, corporation, � QQ 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,,,,,•,•,•,,,,•, O w 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 S Q
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) 400 Public or private company 48• Number of stories................
31 D Wood frame 410 Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 0 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 1. TYPE OF MECHANICAL 51. Enclosed .......................
35 F7 Gas Will there be central air 52. Outdoors........................
36 Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 Electricity 44 [—] Yes 45 jLF No 53. Number of bedrooms..............
38 Coal
39 n Other Specify Will there be an elevatoro Full..........
54. Number of
46 n Yes 47 Ej No bathrooms Partial........
DEPT. OF BUILDING INSPECTIONS BUILDING Z
! 212 Main Street $a
Northampton, MA 01060 PERMIT
29 - 191 VALIDATION
DATE_ July 3, 19 85 PERMIT NO. 383
APPLICANT Teddy Bear Pools ADDRESS Chicopee
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO Addition (_) STORY Above Ground Pool NUMBER OF
DWELLING UNITS
(TYP F IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 127 Deerfield 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: permit for the installation of an above ground pool in rear of existing dwelling
AREA OR 24' diameter 21500.00 PERMIT 10.00
VOLUME ESTIMATED COST $ FE ,
(CUBIC/SQUARE FEET)
OWNER Elizabeth A. Morrey
ADDRESS eer le lve, renc a . BYl I / is
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pjNT IIP