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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name / Mailing address - Number, street, eity, and State ZIP code Tel. No.
Owner or �rt ��q� H t� Cl)-4 A&,*. �ry /�/ �1�/ f!!/�
Lessee kt u r AlLoo f-.e 7"� 7„ A-1 C r I A' `) S e�(�a o Bui
2. ,6F/LT /_ ,r, J� j'� V.. ; ] ceIder's 60 -176
''�-` N v License No.
Contractor
A-4ASddl, All *1336 G 13Lf9G
A it S 0 . .�� 1 -e
Architect or
Engineer L !� a
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 Addr ss Application date
6-)/ A� K'9_
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 Is
OTHER Is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obtained Number By Permit or Approval Check 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
VII. VALIDATION
Building /� / FOR DEPARTMENT USE ONLY
Permit number c
Building Use Group
Permit issued a 19
Building Fire Grading
Permit Fee $ J`�� �
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�+ MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page — Plot T'i APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
I. IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX.
O
ZONING
AT (LOCATION) A 7 DISTIT
LOCATION (NO.) (STREET)
OF BETWEEN &0k�, � f'i' -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 rr1
M
1 ❑ New building Residential Nonresidential
2 ❑ Addition(If residential, enter number 12 [_1 One family 18 ❑ Amusement, recreational
of new housing units added, if any,
in Part D, 13)
13 4�Si Two or more family - Enter 19 ❑ Church, other religious
3 Alteration (See 2 above)
number of units- - - -- 20 ❑� Industrial
®
14 ❑ Transient hotel, motel, 21 Parking garage
4 ❑ Repair, replacement or dormitory - Enter number
5 ❑ Wrecking (If multifamily residential, of units ------- -- --0. 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) 'p, 25 Public utility
17 � Other - Speci/y� ❑ Y
7 ❑ Foundation only
/� 26 ❑ School, library, other educational
B. OWNERSHIP EJl� ��) yt tbi. 27 ❑ Stores, mercantile
8 ❑Private (individual, corporation,
28 ❑ Tanks, towers
nonprofit institution, etc.) 0 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 ..................... p
c. Heating, air conditioning..........
d. Other (elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT $ �-�t ®��
111. 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 rgPublic or private company 48. Number of stories................ J
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 OF WATER SUPPLY
34 ❑ Other - .Specify 42 Public or private company 50. Total land area, sq. ft. ........... �� G00
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 7K No 53. Number of bedrooms.............. 3
38 ❑ Coal
39 ❑ Other - Specify Will there be an elevotoO Full.......... 91
- 54. Number of
46 [-1 Yes 47 [�tNo bathrooms 6`?;A1 /
Partial........ CLJ�}riKu9J7�
DEPT. Of BADING INSPECTIONS BUILDING '°
! 212 Main Street
Northampton, MA 01060 PERMIT <a
25C - 34 VALIDATION
DATE November 25, 19_ 86 PERMIT NO. 691
APPLICANT Robert Wilson ADDRESS Bug Hill Rd. , Ashf ield 013496
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO Alteration (_) STORY One Family Dwelling DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION)
27 Northern Ave.
ZONING
ISTR CT URB
(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: partial °"'rimjt for work to he done only on one Side of existing dwell 'na
Kitchen alterations, entry
AREA OR PERMIT
Rn Cnr. ft ESTIMATED COST $ ��,Qnn_nn FEE $ 52-00
VOLUME Q
(CUOIC/SQUARE FEET)
OWNER Gone Friorilawio Mauureen MOOre —
BUILDING
9 Dt?PZ. ,fit +�� a:•-
ADDRESS 7 No rn rthe Ave . N"thampten BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK ASSESSORS COPY podp