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NOTES and Data — (For department use)
J.i-/-// 1,we 1 -:-
1-2,4,IdIll '/ 132v
C I T Y O F N O R T H A "! F T O C , M A S S.
June 19, 19 85
THE BGARD OF FU3LIC ;O'ORKS
The un(lersi.,ned respectfully petition your honorable body for
permission to install a driveway at lot #MW Ladyslipper Lane in
"Tinkham Woods", off of Westhampton Road. Twenty-four (24) maximum
width at the Street line. Gutter drainage not to be disturbed.
Driveway surface to be paved if the grade of the proposed driveway
exceeds 3% or more.
By:
- Lawrence u e e
65 White Loaf Road
Southampton 527-7766
Inspected By:
THE BOARD G=
Voted thrit petition he :;ranter', .
Acting D Yrector 0 f ub. c Works
IV. IDENTIFICATION — To be completed by all applicants
Name /� / Mailing address Number, stmt, city, and Statr ZIP code STel. No.
Owner or /✓� ( 1 II- 0
W
Ld7
essee 3
/ Builde.'s D�j 37
1, L tens e N o.
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
i
f , Ze
00 NOT WRITE EL0 THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Dote Permit or Approval Check Obtained Number By Permit or Approval Chec Date
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
II. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building.
Permit issued L�C1 � 1q��j Use Grasp
Building Fire Grading
Permit Fee $ �� Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
3 OFFICE of the INSPECTOR of BUILDINGS
Page � � * Plot ❑ APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT/—j�Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O ZONING
(• AT (LOCATION) � X/- �+�- � �(7 ✓/II L• DISTRICT 5�<
LOCATION (NO.) (STREET)
OF BETWEEN ()J-lo r( �- AND
BUILDING 1 (CROSS STREET) / (CROSS STREET)
LOT
SUBDIVISION / ;1�3�'J ��fJj� LOT ` `3 BLOCK SIZE
to
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D A
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use to
m
1 New building Residential Nonresidential
2 ❑ Addition(1/ 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 l
l
t
h
i
Transent hotel, mote ,
❑ 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory - Enter number
5 ❑ Wrecking (if multifamily residential, Of units ------- - -i 22 ❑ Service station, repair garage
enter number of units in building in 15 Garage 23 ❑ Hospital, institutional
Part D, 13)
6 ❑ Moving (relocation) 16 Carport 24 ❑ Office, bank, professional
7 ❑ Foundation only 17❑ Other - Specify 25 ❑ Public utility
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
6 Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 ❑ Other - Specify
9 L❑ 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,,,,,,,,,,,,,,,, 5 Q 00 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..................... �(1t1r
b. Plumbing .....................
c. Heating, air conditioning.........
d. Other (elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT 3 l �0 U
III. SELECTED CHARACTERISTICS OF BUI DING — 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 �1
30❑ Masonry (wall bearing) 40 ❑ Public or private company 48. Number of stories............... r�
31 [7X Wood frame 41 ® Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior
32 ❑ Structural steel dimensions ..................... L
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other - Specify 42 ® Public or private company 50. Total land area, sq. ft. ........... b 31OL?
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES -y
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ....................... i
35 ❑ Gas Will there be central air 52. Outdoors........................
conditioning?
36 � Oil L. RESIDENTIAL BUILDINGS ONLY
37 �❑ Electricity 44 ❑ Yes 45 ,K] No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other - Specify Will there be an elevator? Full..........
54. Number of .
46 ❑ Yes 47 10 No bathrooms I
Partial.......
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