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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
1.
Owner orOGSh f Pi eez.
Lessee
' r/CT`4/1 Iufi� LBcenser
2. �
N0. 5�7
Contractor r
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.
1!1L applican Address Application date 4A Z
t &U ii' �C'E' /))/j
l� <?� c.ir cr
0 OT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re wired Check Plan Review Date Plans By Plans B Notes
Q Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL Is
OTHER Is
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obta ned 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 b rt FOR DEPARTMENT USE ONLY
Permit number '7f
Building / Use Grou p
Permit issued � 19
Building \ Fire Grading
Permit Fee $ " i Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�• MASSACHUSETTS
OFFICE of ", e INSPECTOR of/BJJILDINGS
Pa g e Plot �7 APPLICATION FOR
�=r
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O
AT (LOCATION .1• , r / / DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN t.A AND
BUILDING (CROSSf 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 M
M
1 ❑ New building Residential Nonresidential
2 LJ Addition(lf residential, enter number 12 ❑One family 18 ❑ Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 n Two or more family - Enter 19 Church, other religious
3 Alteration (See 2 above)
number of units- - - - -� 20 L❑ Industrial
❑
14 ❑ Transient hotel, motel, 21 Parking garage
4 ❑ Repair, replacement or dormitory - Enter number -�
5 ❑ Wrecking Of multi family residential, of units ------- - ---- 22 Service station, repair garage
enter number of units in building in 15 yr❑ Garage 23 Hospital, institutional
Part D, 13) ❑
16 Carport 24 F "� Office, bank, professional
6 ❑ Moving (relocation)
❑ 17 ❑ Other - Specify 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 L❑ Other - Specify
9 ❑❑ Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential - Describe in detail proposed use of buildings, e.g., food
l 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 is
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 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. ft. ........... • •
\ 43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
'
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed .......................
35 ❑ Gas Will there be central air 52. Outdoors........................
36 ❑ Oil r conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 Yes 45 ❑ No
L--1 ---. 53. Number of bedrooms..............
38 ❑ Coal
39❑ Other - Specify Will there be an elevator? Full..........
�� 54. Number of
46 C Yes 47 L__J No bathrooms
Partial.......
DEPT. OF BUILDING INSPECTIONS BUILDING o°- X�
Northampton, MA 01060 PERMIT <a
29 - 41 VALIDATION
DATE April 21 , 88 PERMIT No.
APPLICANT Carpenters Association _ ADDRESS 1 ul —rp y Terr, w Tr Signed Off
A11ddduitii�o,yn��/.yy (NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO X1ol(dYlY4X/�Q�4AAK X (,) STORY Deck DWELLING UNIT$
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING URA
AT (LOCATION) 59 Pioneer Knolls D STR CT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
H""IS H""IS TO BE 12 FT. WIDE BY 16 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 DECK ONTO REAR OF EXISTING DWELLING 32" HIGH
AREA OR MIT
VOLUME 192 sq. ft $ 10.00
. ESTIMATED COST $ 2,200.00 FEE
(CUBIC/SQUARE FEET) .�
OWNER John Ka p l t 7k/ nn.
B WTOUILDING
Knolls .ADDRESS 59 Pioneer Florence BY «ll.......1..
WHITE - FILE COPY - GREEN - FIELD COPY - CANARY - APPLICANT COPY ■ PINK - ASSESSORS COPY pjNf P