36-107 (2) For ALL buildings within Fire District and for other buildings costing $10,000.00 or more,plans
and specifications must be submitted to the Inspector of Buildings for examination and approval.
If building is to be moved give details relative to proposed location as for a new building.
Application for Permit to Build
Northampton, Mass., ......
. .......L.!.1at ........19»... ..A.t?
To the Inspector of Buildings:-
The undersigned hereby applies for a permit to build, move, alter, or repair, according to the
following specifications.-
� 4 �
1. Owner's name ......»!it.�l»!�yFLI�F. .<.......».»�'v�.l.G:Jul ... a.�� z:.................».......... .....................................................................
' :ty'[ . . K r.�......»..» r.tZt� ��,.-.`...........,...,....._.».
2. Owners address .».. .».... ».......:.. ........ .1. ...........................».,..».......».......».......»........
3. Architect's name ..........................................»..........................»........................... .........».....................................................................
4. Builder's name ... G„;! . t.......»... . !.►-;�:?:f:.......7:.V L»....... r:.s...................................................» ........
5. Builder's address .... &!k...`� .........»L R C:.C,.f................ ......
6. Location of Building. Street No. .......�...`2..........r ;x'Sac F ai.P4._........e.r..'44:..tst.................................».»»............».
7. Is this a removal or new building.................Ac:1cl 7lc ..............�1 :s�: ...............................................».,.....».................
8. If removal, from where ......................................................................................_...........................................»...................»...................
9. What is the purpose of building ....................(Adik.........9.........` ` ........ .........................
10. Material of building ...............+-t.: x . .......»..........S:r .AS-1 ..;L ..,...._....................................................................................
11. If a dwelling, for how many families ....................I..................».....Number of rooms
............. ...................................
12. Is there to be a store in the building ....»....».......! / .....................................».»....».......»..........».............................................
13. Size of building, No. of feet front ........ y».....;No. of feet deep ....1.61........; No. of stories ........&...........
14. Size of ell, No. of feet front ........................: No. of feet deep ...........»........... No. of feet high ..........................
r
15. Size of Lot A...............� .LL...................Feet Wide .........__.................... Feet Deep
16. How near the-line of street ......................................................................................................................»........»......»...............................
17. How near the line adjoining lot. Right......& k».....; .Left........:# ...63�; Rear.....,1Z� ..............
18. Nearest building is
......I ....»........... feet in a....»�.r.�. ..............................»..... direction ......................................................
19. Material of the floor .............. tea . .. .4?..........»........ .........................................................................
20. Size of timbers, 1st ...4ty-!?- ; 2nd ...... ; 3rd ; 4th ; 5th
21. No. of feet span .»........»....I...f ....................................... ; Distance on centers .....»........../..4t..............................................
22. Will the building be erected on solid or filled land ................. ll .. .....................T. .. ..................
Lc?»flx ,.........S kw. .. ..C= ��l�J Footing.......................
23. What is the material of foundation .....»....».»......: ....�... ............
24. Will the roof be flat or pitched ...........».P..i..I".�t Z.»....».....; Covering..........fah!:In.......:� :�. .
25. Heat; steam, hot water, furnace, stoves..........4 ............: Power oil burner...............................................
.............. Insulation 4
26. Fireplace .....».........1.1f.C............»..........»......... ..............»' .1..�.«:.»�j,.�..� .....................................................
27. How many sinks I..; Toilets .....»(...; Lavatories ..».....; Bathtubs.....»..; Showers............: Settubs .........
28. City Service; Water ...........A ....Sewer ...... :..........: Road Surface ........ ...........; Sidewalk .................».
29. Is lot on accepted street ..................... .Je'. ....................................................................................................................................
30. Estimated cost (must be filled out) ...... ....7 ..........
Applicant agrees to give the Inspector of Buildings 24 hours' notice before lathing or
plastering this building. This building will conform to the requirements of the law.
. .L::le.1," ....... ........................
Signature of applicant
No...........G..: ..»....»...........
REMARKS
.................................................»..................................»...........................................................................».............»..............................».........................................
...».......»...........»......»......................................».........................................................................................................................................................I.............................
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PLOT PLAN
In accordance with Article XI of the Zoning Ordinance, an application for a ,
Zoning Permit muat include a Plot Plan. The following characteristics of the
parcel must be shown.
1. Dimensions of the lot.
2. Locations and size of all. buildings.
3. Average finished grade of all structures existing and proposed.
4. Use of all buildings existing and proposed.
5. Set Backs as indicated on the enclosed plan.
A.butto s Name
Lot 2 No.
Lot' t-2_ I71 t.
Re ar Yard
Abuttors Abuttors
Name Name
Lot No. Lot /t 2 No.
�' d
House ~Sideyard If this is a
If this is a 4• Sideyard corner lot, write
corner lot, write in the name of the
in the name of the
other street.
other street.
tt
{ Sot Back
o °
Lot�`�'L Ft.
Name of Street
Indicate location of garage or accessory buildings with a dashed line.
Indicate location of Sewer hook—up S
List all past plans, applications, permits, variances etc. and corresponding dates that
have been. processed by this office.
I certify that the enclosed applica ' n and plot p e com ete an correct.
Signature of Owne Date
PageNo. Lot No./L ,6:' -
o. L -1 l
81.0 107 - 106
APPLICATION
vine
Telephone Telephorn
�nrk the mpprnpiate box to iodic�ito tbo vup of t}/r p�,ropI:
-
F--1 Fon-CnnforminC Lct ,nd/nr 3trocture. Slmcify '----------�----------
' -------------'------------- --'-------------
Re�idcatj �I ioCIe F�,i]7 Ouit [--l[uItl-FooiIy
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F--lDoy,Iez |--lOtbcl.
�--lBuoiueno
F--� Industrial
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F--1 �ubdlviaino �--^ [`� � `--^ ^ ^ ^
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[--l8obdiv1olon �itb
F-_) PIouuin� Board �pyron�I:
[--lZoning Bourd Approval (Spcc- nI Permit I(1.cl): vccl"3.71u0
= City Council (IS'peciil Exccption )
Plot Plan Yes ro Site Plan Yes ':T o
This section for OFIICIkL use onIy:
��mlApprovaI as presented:
54]
Approval
censcczzy for -rprnrrI:
F--lBmtvrn; (l[ore inforir.-tiro ueclod)
DeoioI: Ro-rnre;
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I hereby certify that the proposed work is authorized by the owner of record
and i have been authorized by the owner to make this application as his
authorized agent.
SIGNATURE OF AGENT 4
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 14
DEPT. FILE COPY
Zp
BUILDING
PERMIT VALIDATION
DATEMay 18 19 76 PERMIT NO. # 150
APPLICANT Gormely Construction Inc • ADDRESS 2 Brookside Circle
(NO.) (STREET) (CONTR'S LICENSE)
.I NUMBER OF
PERMIT TO construct (1) STORY addition DWELLING UNITS 'single
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
247 Brookside Circle ZONING URA
AT (LOCATION) DISTRICT
(NO.) (STREET) _
a BETWEEN AND
'D
o, (CROSS STREET) (CROSS STREET)
IL LOT
m SUBDIVISION ry LOT BLOCK SIZE
p BUILDING IS TO BE 18# FT. WIDE BY -.L�._.FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
Z TO TYPE 4 USE GROUP Z"3 BASEMENT WALLS OR FOUNDATION lolly columns
f
� (TYPE)
O
LL REMARKS:
AREA OR
VOLUME 306 sq• ft. ESTIMATED COST $ 7 ,000.00 FEEMIT $ 21 #00
(CUBIC/SQUARE FEET)
OWNER Mathhew Mickiew is z
ADDRESS 247 Brookside Circle BUILDING T.
BY
(Affidavit on reverse side of application to be completed by out zed ent of owner)