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NOTES and Data — (For deportment use)
r
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address Number, street, arty, and State ZIP code Tel. No.
Owner or
Lessee
Bu.Ider'Ns
Z L,cense 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 oj�plication as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature o plicant Address Application date
00 NOT W R I T E BELOW T H I S L I N E
V. PLAN REVIEW RECORD For office use
Plan Review Date Plans By Dote Plans By Notes
Plans Review Required Check Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date De
Permit or Approval Check Obtained Number By Permit or Approval Check Obtaatined 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
Permit number s FOR DEPARTMENT USE ONLY
Building CY Use Group
Permit issued 2ee I e,VdV, /-5 19 Aj 1
Building Fire Grading
Permit Fee Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $ gr
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�� •� MASSACHUSETTS
± OFFICE of the INSPECTOR of ?BUILDINGS
r Page '3 Plot 2/ -L7 APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT - Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
I• AT (LOCATION) ZONING/`' �/``V �d``1°'- "Y DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET) '
SUBDIVISION ri ""�If' /.�. ' � LOT rat BLOCK SIZE
to
11. TYPE AND COST OF BUILDING - All applicants complete Parts A - D -t
A. TYPE IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
m
1 building Reside i
2 al Nonresidential
❑ Addition(If 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) 1q 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 — Specify 25❑ Public utility
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNEF2SHIP 27 ❑ Stores, mercantile
8 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,,,,•,•,•,•,,,,, 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.)............. ,sue
11. TOTAL COST OF IMPROVEMENT Is tCw
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 asonry (wall bearing) 40 ❑ F�ublic or private company 48• Number of stories............... 2,
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 F WATER SUPPLY
34 ❑ Other - Specify 42 Public or private compony
50. Total land area, sq. ft. ........... Z,j
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL 1. TYPE OF MECHANICAL 51. Enclosed ....................... L
35 FG as Will there be central air 52. Outdoors........................ 2
36 ❑ Oil conditioning
L. RESIDENTIAL BUILDINGS ONLY _
37 Electricity 44 ❑ Yes 45 �0 53. Number of bedrooms.............. J
38 ❑ Coal
39 ❑ Other - Specify Will there be an elevator? Full..........
54. Number of
46 ❑ Yes 47 �No bathrooms partial........
a DEPT, OF BUILDING INSPECTIONS
BUILDING
212 Main Street o<
Northampton, MA 01060 PERMIT <a
VALIDATION
36 - 77-16
DATE geeeFabpr I; 19_ PERMIT NO. 721
APPLICANT Progressive Structures ADDRESS 68 Winterberry Lane 039141
(NO.) (STREET) (CONTR'S LICENSE)
New Building NUMBER OF
PERMIT TO _(_) STORY One FAmi ly�GarageDWELLING UNITS +1
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION)
Lot #16A Birch Lane DIISTR CT SR
(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 construction of a new Single family dwelling with aaraae
AREA OR 1 n PERMIT
VOLUME 2096 ESTIMATED COST $ � nnn_nn FEE f/ l
( � IC/SfRE
_
FEET) `
OWNER Henry L i rl i P BUI I 'Ji ''�✓ ✓,%
ADDRESS 68 Wi ntPrhPrry I anP BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY p0INTSIIP
Gritp of Northampton �\
9 � ,$�4xesxchnsettx — - -
® (Offsre of tilt Ynoptrtor of Auilbings
212 Main Street•Municipal wilding
Northampton, Mass. 01060 =
#721
CERTIFICATE OF OCCUPANCY
September 30, 1987
Page No. 36 Plot 77-16
Building (Name) New Single Family Dwelling/Garage Address Lot #16 Birch Lane
Owner Henry Fairlie Address 68 Winterberry Lane
Applicant Progressive Structures Address Same
Use: 1st Residential Occupancy
2nd Residential Occupancy
3rd Occupancy
4th Occupancy
Zone District SR
Required Inspections:
New Building X Existing Building
Elevator Electrical --
Plumbing S.D. Fire f
Building ' " GAS. Other
inspector of Buildings