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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. nature of applicant Address Application date DO N O T W R I T E BELOW T H I S LINE V. PLAN REVIEW RECORD For office use Plan Review Date Plans Date Plans Plans Review Required Check Fee Started By Approved By Notes 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 VII. VALIDATION Building FOR DEPARTMENT USE ONLY Permit number J Building Use Group Permit issued 19 107 Building Fire Grading Permit Fee $ 114 n Live Loading Certificate of Occupancy $ Occupancy Load Approved by: Drain Tile $ • Plan Review Fee $ TITLE CITY OF NORTHAMPTON g. MASSACHUSETTS $ OFFICE of the INSPECTOR of BUILDINGS �t 1 . Page — Plot_.;` 5 APPLICATION FOR INSPECTOR ZONING PERMIT AND BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O r72 /yyl .,/• � 'J _1 ZONING • AT (LOCATION) '-1' ( it rY DISTRICT LOCATION (NO') (STREET) O F (' BETWEEN j.� '✓-/' ;�'-'�_ - _AND BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE N II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D ;0 A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m m 1 ❑ New building Residential Nonresidential 2 ❑ Addition(If residential, enter number 12 One family 18 E] 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- - - - i 20 ❑ Industrial 3,X 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 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) 17 ❑ Other - SpeciJy 25 ❑ Public utility 7 ❑ Foundation only 26 ❑ School, library, other educational B. OWNERSHIP 27 Stores, mercantile 8 LX Private (individual, corporation, 28 Tanks, towers nonprofit institution, etc.) 29 ❑ Other - Specify 90 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 $ I.-///_ ,_v. 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 L❑ Public or private company 48. Number of stories.............. 31 ❑ Wood frame 410 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. 41. .......... 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 Yes 45 ❑ 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....... DEPT% OF WILDING INSPECTIONS BUILDING �° ! 212 Main Street Oa l� Northampton, MA 01060 PERMIT 35 - 23 VALIDATION DATE May 13, 87 PERMIT O. 282 APPLICANT Dennis A. Seymour ADDRESS eFFarms Road Owner (NO.) (STREET) (CONTR'S LICENSE) Addition One Family UMBER OF PERMIT TO (_) STORY Y DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) 50 West Farms Road ZONING SR 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 the addition of a bedroom 10' X 12' onto the rear of existing dwelling AREA OR 120 $q, ft. ESTIMATED COST 1 1200.00 FEEMIT 10.00 VOLUME (CUBIC/SQUARE FEET) 7 OWNER Same as Applicant I BUILD , ADDRES - -Same as Applicant's BY WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY ■ PINK - ASKS ESSORS COPY pjNT` P