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IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and Smote .AM- ZIP code Tel. No.
ovine, or 6�1e 13 �/T SA -s1.24
/oct�
Lessee S RWCC 1rA o166o
Bw lder's
2, 0, 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 date
7v y 1�v rm P T e�b / aZ
00 NOT WRITE BELOW 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
Date D
Permit or Approval Check Obta ned Number By Permit or Approval Check a Obtt t ed 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 �/yC� FOR DEPARTMENT USE ONLY
Permit number I
Bui Iding Use Group
Permit issued � �Q� 19
Building 1 j'+� Fire Grading
Permit Fee $ O Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
11�� TITLE
CITY OF NORTHAMPTON
10 MASSACHUSETTS
QFFICE of the INSPECTOR of BUILDINGS
Page 36 Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O
n ZONING
I• AT (LOCATION) r ve /,0 r?� �/� is DISTRICT��
LOCATION (N0.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
V1
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 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 fami ly — Enter 19 ❑ Church, other religious
number of units— — — — —> 20 ❑ Industrial
3 Alteration (See 2 above) 14 l
l
h
Transient 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) 16 ❑ Carport 24❑ Office, bank, professional
6 ❑ Moving (relocation)
17 t�4 Other — Specify 1 t CA 25 ❑ Public utility
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP clt�ol— 27 ❑ Stores, mercantile
8 Ex Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 ❑ Other — Specify
9 ❑ 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,,,,,,,,,,,,,,,, schol, secondary school, college, parochial school, parking garage for,
deparotment 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 area,
all floors, based on exterior //Vr X/
320 Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 � Other — Speci/y �- 1� 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 conditioning?
� L. RESIDENTIAL BUILDINGS ONLY
37❑ Electricity 44 ❑ Yes 45 ! No 53. Number of bedrooms.............. Al
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevator? Full..........
54. Number of
46 ❑ Yes 47 ❑ No bathrooms Partial........
DEPT. OF BUILDING INSPECTIONS BUILDING �°
! 212 Main Street Oa
• Nort"h�'npton, MA 01060 PERMIT
36 - 194 p VALIDATION
DATE October 26, jg 84 PERMIT NO. 599
APPLICANT Ellen T. Stiles ADDRESS 788 Burts Pit Road Owner
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO (_) STORY g
Addition In round Swimming, Pool DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
788 Burts Pit Road ZONING SR
AT (LOCATION) DISTRICT `
�
(N0.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
POOL
IS TO BE 18 FT. WIDE BY 36 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: permit for the installation of an inground swimming pool in rear of existing
home.
AREA OR 648 sq. ft. ESTIMATED COST $ 3,610.00 PER FEE
$ 10.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER Donald < Ellen Stiles BUILDI
ADDRESS 788 Rurts Pi t Pond BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY • APPLICANT COPY • PINK - ASSESSORS COPY PJNf SNP