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IDENTIFICATION — To be completed by all applicants Name Mailing address — Number, street, city, and State ZIP code Tel. No. Owner or ✓. �. VLC. Y+#.,. xrt's- ✓. Oi66 © 9, Lessee A Builder's 2. c: w t �j d+V x T`�C/ / `!. 5 K License No. V/ �47rc7 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 : 7/ Ate' /`f—$Q 00 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Required Check Plan Review Date Plans B Date Plans Fee Started y Approved By Notes BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL Is OTHER Is VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approval Check Date Number B Permit or Approval Check Date Number B Obtained y pp Obtained y 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 / FOR DEPARTMENT USE ONLY Permit number Building ''}/�/f {', Use Group Permit issued " ' t� Iq 0 ,0 Building Fire Grading Permit Fee $ �`/'��U Live Loading Certificate of Occupancy $ Occupancy Load Approved by: Drain Tile $ ; * £ d Lo t= Plan Review Fee $ TITLE CITY OF NORTHAMPTON �. .� MASSACHUSETTS OFFICE of the INSPECTOR of BUILDINGS Paged Plot—S; APPLICATION FOR ZONING PERMIT AND INSPECTOR BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: 1, II, 111, IV, and IX. O ZONING ( Nei `^/.y DISTRICT I• AT (LOCATION) I`✓ Q /►UI°'7�•' ✓! LOCATION (NO.) (STREET) OF BETWEEN AND BUILDING (CROSS 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 E New building Residential Nonresidential 2❑ Addition(If residential, enter number 12t< 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;K Alteration (See 2 above) 14 Transient hotel, motel, 21 parking garage 4 Repair, replacement or dormitory — Enter number 5 � Wrecking ((J 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) 25 Public utility 170 Other — Specify 7 F__j Foundation only 26 School, library, other educational B. OWNERSHIP 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,,,,,,,.,..•.... 00� Od 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..................... 00 D,0 b. Plumbing .................... c. Heating, air conditioning......... d. Other (elevator, etc.)............. 11. TOTAL COST OF IMPROVEMENT $ZZO 11.Oa 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 D Public or private company 48. Number of stories.............. 31 Wood frame 41 0 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 51. Enclosed ....................... F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 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.............. 38 Coal 39 n Other — Specify Will there be an elevatoro SG. Number of Full.......... — 46 [ ! bathrooms � Yes 47 No Partial........ DEPT. OF NILDING INSPECTIONS UILDING - ��< 212 Main Street Oa Northampton, MA 01060 PERMIT ' 25C - 8 VALIDATION Gerald R. ArchambauftrE March 14, 19 88 PERMIT NO. 116 APPLICANT ADDRESS 171 West St. . West Hatfield 010788 88 1NO.? (STREET) (CONTR'S LICENSE) PERMIT TO Alteration (_) STORY One Family DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) AT (LOCATION) 15O Nnrth StrPPt ZONING URB (NO.) (STREET) DISTRICT 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 to close in back porch creating mud room and spa room AREA OR 2,200.00 PERMIT 10.00 VOLUME ESTIMATED COST $ FEE $ (CUBIC/SQUARE FEET) a! OWNER Gerald Archambault, Sr. �_��"�'� ADDRESS or Street, Northampton, Mass. BUILD WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY I, Al P