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IDENTIFICATION — To be completed by all applicants ate— /Name f Mailing address — Number, street, city, and State ZIP code T Owner or Lessee 2 / d/� 4 j Builder's Contractor License No. 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 00 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 Fee Started y Approved y BUILDING $ PLUMBING $ MECHANICAL $ 1 ELECTRICAL $ A I J OTHER $ VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approval Check Date Number B Permit or Approval Check Date Number B 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 Permit issued _ ` `�1•L� � fq use Group Building Fire Grading Permit Fee Live Loading Certificate of Occupancy $ Occupancy Load Approved by: Drain Tile $ Plan Review Fee $ TITLE CITY OF NORTHAMPTON MASSACHUSETTS OFFICE of the INSPECTOR of BUILDINGS �-� , ..,t Page Plot APPLICATION FOR ZONING PERMIT AND INSPECTOR BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. 0 J ZONING I• AT (LOCATION) 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 rn rn 1 ❑ New building Residential Nonresidential 2❑ Addition(If residential, enter number 12 One family 18❑ Amusement, recreational of new housing units added, if any, 13 ❑ Two or more family - Enter 19 ❑� Church, other religious in Part D, 13) number of units- - - - -i 20 Industrial 3'SK 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 ------- - -� 22 L� 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) 1T�L}-9ther Specify— 25 ❑ Public utility 7 ❑ Foundation only 26 ❑ School, library, other educational B. OWNERSHIP r 27 ❑ Stores, mercantile 8 K 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 �j 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 48. Number of stories......... 30' .Masonry (wall bearing) 40 ❑ Public or private company 41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area, 31 ❑ Wood frame p all floors, based on exterior 32❑ Structural steel dimensions ..................... 33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY Public or private company 50. Total land area, sq. ft. .......... 42 34 ❑ Other - Specify ❑ p p y 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 Fj Yes 45 ! ' No 53. Number of bedrooms............. 38 ❑ Coal 39 ❑ Other - Specify Will there be an elevators 54. Number of Full.......... - 46 ❑ Yes 47 ❑ No bathrooms Partial....... «, w DEPT. OF BUILDING INSPECTIONS BUILDING '° 212 Main Street O< *Northampton, MA 01060 PERMIT 29 - 251 VALIDATION DATE May 28, �9 $6 ERM T NO. 272 APPLICANT _, Adree Anolik ADDRESS k I�riv� Owner (NO.) (STREET) (C QNT R'S LICENSE) OF Alteration One Family NUMBERNG UNITS PERMIT TO (_I STORY (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) 61 Overlook Drive ZONING UKA 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) REMARKS. permit for masonary fireplace with 2 flues/one for woodstove and chimney outside house AREA OR ESTIMATED COST $ MMMM-Ex 2f000.0JEEMIT $ 10.00 VOLUME (CUBIC/SQUARE FEET) OWNER Same as Applicant 9 , Z Same as pp 1C BBYILDI j, ADDRESS GAL WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSE SORS COPY P'INf IIP