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FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailirig address — \'umber, street, city, and State code Tel. No.
Owner or
Lessee
I
Builder's
2, 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
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
q Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
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
VII. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building ��� use Group
Permit issued 19
Building ` /�.f� Fire Grading
Permit Fee $ I l >>( _:'
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�• MASSACHUSETTS
$ e 0*00i OFFICE of the INSPECTOR of BUILDINGS
Page Plot — APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT - Applicant to complete all items in sections: 1, 11, lll,, IV, and IX. O
I. AT (LOCATION) — / C2
1 l j.") l)1 e(-"i} N K re Ice- ZONING
1--I J„�"-+ DISTRICT
LOCATION (NO.) (STREET)
�X�C}
OF BETWEEN L' 'G5 r'Jt �lY'iL,C AND f CI l_C lC'
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
i New building Residential Nonresidential
2 Addition(If residential, enter number 12 LLS One family 18 Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 i Two or more family - Enter 19 Church, other religious
number of units- - - - >20� 1 Industrial
3 Alteration (See 2 above) _
14 _ Transient hotel, motel,
4 Repair, replacement or dormitory - hwter number 21 -� Parking garage
5 Wrecking (If multifamily residential, of units- ------- - -- 22 Service station, repair garage
enter number of units in building in 15 Garage 23 Hospital, institutional
Part D, 13)
16 7� j Carport 24 Office, bank, professional
6 Moving (relocation) r
17 [-] Other - Specify 25 t. J Public utility
7 Foundation only
26 � � School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 Vq Private (individual, corporation, 28 ` Tanks, towers
nonprofit institution, etc.) 29I J Other - Specify
9 Cj 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....................... 1/�•-Eli t
b. Plumbing ....................... I�/ X r ,�
c. Heating, air conditioning.......... !�
"P
d. Other (elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT $
Ili. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Ports E — L;
for wrecking, complete only Part J, for all others skip to /V.
E. PRINCIPAL TYPE OF FRAME 1G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
30 ( l 1 48. Number of stories................
L-I Masonry (wall bearing) 40 Public or private company -----
31 F] Wood frame 41 ! Private !septic tork, etc.) 49. Total square feet of floor area,
_ all floors, based on exterior
32 L_- Structural steel -___._---_—_ - dimensions .....................
33 j Reinforced concrete H. TYPE OF WATER SUPPLY
3411—i Other Sreci y 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 j' Electricity 44 I Yes 45 _ No 53. Number of bedrooms..............
38 C_.1 Coal
39 ( 1 Other - Specify Will there be an elevatory 54. Number ull..........
ber of
46 Yes 47 -D No bothrooms Partial.......
DEPT. OF BUILDING INSPECTIONS BUILDING ZO
212 Main Street 0 1D •L)D Northampton, MA 01060 PER MIT
29 - 271 VALIDATION
DATE `Tune 23 19 88 PERMIT NO. M 381
APPLICANT Francis & Ellen Baldwin ADDRESS 0118 eVi w Dr. owner
INO.) (STREET) (CONTR'S LICENSE)
Alteration One family UMBER OF
PERMIT TO (,) STORY y DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
71 Longview Dr. Florence ZONING iJ
CT M
AT (LOCATION)
(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 an above ground pool 15' X 30' with L sha ed deck around it.
ectrica permit required.
AREA OR VOLUME ESTIMATED COST $ .ODD.00 PERMIT $ 10.O0
(CUBIC/SQUARE FEET)
OWNER Francis & Ellen Baldwin NFO. '
BUILDIN
ADDRESS 71 L mgvlew Dr. Fl )ren _e BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY ^ APPLICANT COPY • PINK ^ ASSESSORS COPY p- p