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DISTRICT
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NOTES and Data — (For department use)
41
1`2 YCI
�1-
/dd
I
IV. IDENTIFICATION To be completed by all applicants
Name Mailing address Number, street, city, and State ZIP code Tel. No,
Owner or
Lessee
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 dote
//7
DO NOT W R I T E B E L O W T H I S L I N E
V. PLAN REVIEW RECORD For office use
Plan Review Date p Ions Dote Plans
Plans Review Required Check Fee Started By Approved By Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
V1. 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
VII. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number Ab
Building L Q Use Group
Permit issued 19
Building Fire Grading
Permit Fee Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
` CITY OF NORTHAMPTON
�. .� MASSACHUSETTS
r r
$ f OFFICE of the INSPECTOR of BUILDINGS
T
Page— �� Plot 23 APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O
ZONING
I• AT (LOCATION) �,1 �." '/
DISTRICT �Q.
LOCATION (NO') (STREET)
OF BETWEEN ')t AND (CROSS STREET)
BUILDING (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 m
m
1 "New building Residential Nonresidential
2 F-1 Addition(If residential, enter number 12❑ One family 18 Amusement, recreational
of new housing 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 multi family 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 L_� Carport 24 Office, bank, professional
6 Moving (relocation)
17 Other — Speci/y 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 (0mil 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 $ ��
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 are
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 Will there be central air 52. Outdoors........................
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 C] Electricity 44 Y 45 t -,y, No
❑ es � 53. Number of bedrooms..............
38 Coal
39 n Other — Specify Will there be an elevator? 54. Number of Full..........
46 [_� Yes 47 '_j No bathrooms
Partial.......
DEPT. OF BUILDING INSPECTIONS BUILDING �O a.
212 Main Street 0
Northampton, MA 01060 PERMtT 1a
35 - 23 VALIDATION
.
DATE 0 .nber 6. 19 87 PERMIT NO. 606
APPLICANT Dennis Seymour ADDRESS 50 West Farms Road _ Owner
IND" ISTREET) (CONTR'S LICENSE)
NUMER OF
PERMIT TO New Building (_) STORY Detached Garage DWELL NG UNITS
(TYPE OF[IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 50 West arms oa DISTR CT SR
(N0.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION //II LOT BLOCK SIZE
BUILDING IS TO BE 24 FT. WIDE BY 24 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS; permit for the construction of a new detached garage (2 car)
AREA VOLUME 576 $Q• ft. 4�500.00 PERMIT 18.00
ESTIMATED COST $ FEE
(CUBIC/SQUARE FEET)
OWNER Same as Applicant
Same as Applicant' s Bu"�
ADDRESS BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY a PINK - ASSESSORS COPY pjNT P