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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants '
Name Mailing address — \'umber, stmt, city, and State _ ZIP code Tel. No,
Owner or
Lessee / F'/,�,�ooc M� 4}
ail �. Ni /'I dle 90 Buin er's .I (
2. L./1 � (� � t�,�j �� License No.
Contractor (.+,
car
.1 tv i~
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
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 I is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obtai ed 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
Building n Q Use Group
Permit issued `�� — 19
Buildin g • Fire Grading
G r /%n
Permit Fee $ = •iceA Z Live Loading
Certificate of Occupancy $ Occupancy Load
Approv J
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
MASSACHUSETTS
e OFFICE of the INSPECTOR of BUILDINGS
Page—C2- Plot 16 APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items
i-n- s�etctions::/ 1, 11, 111, IV, and IX. O
I. \/ ( !`, ✓f
DISTRICT
AT (LOCATION)
LOCATION (N0.) (5 VR EET) /
OF BETWEEN V N � AND ��Ies DoIP�J<'"�� tT�
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 [ lew building Residential Nonresidential
2❑ Addition(If residential, enter number 12�ne 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)
14 ❑ Transient hotel, motel, 21 Parking garage
4❑ Repair, replacement or dormitory - Enter number
5 ❑ Wrecking (I/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
Q26❑ 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
tCr processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement................ f? . 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 "
o. Electrical.......................
b. Plumbing ..................... � F _
c. Heating, air conditioning
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $ �Ca
III. SELECTED CHARACTERISTICS OF BUIL ING — 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
32 ❑ Structural steel dimensions ..................... )`'f
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 F__1 Other - Specify 42 F-1 Public or private company 50. Total land area, sq. ft. ..........
43 [j;4Private (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........................
conditioning?
36 Oil Vol' L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 ❑ Yes 45 No 53. Number of bedrooms.............
38 ❑ Coal
39 ❑ Other - Specify Will there be an elevators Full..........
- 54. Number of
46 C Yes 47 IZNo bathrooms
Partial......
DEPT. OF BUILDING INSPECTIONS Z
BUILDING 'D- ,�
t 212 Main Street o
Northampton, MA 01060 PERMIT <a
28 - 16A VALIDATION
DATE j1)nP 2, 19 R_ PERMIT NO. 320
APPLICANT ADDRESS QIA RT 04664R
(N0.) (an EEd 1
(CONTIPS LICENSE)
PERMIT TO New Building (,) STORY One Family DWELL NG UNlTS +1
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) Lot #16A Sylvester Road D ZONING RR
STN CT
(N0.) (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, DermitiRkthe construction of a new XX single family dwelling with 2 floors/no garage
VOLUME 2200 sQ. ft. ESTIMATED COST $ 104,5500.00 FEEMIT $ 660.00
(CUBIC/SQUARE FEET)
OWNER Mark & Kathy LaValley
ADDRESS 260 Acrebrook Drive, Florence BUILD! BDDEPT.
BY
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY PjNfS P
Lrit� of Wort4ampton
e Offirt of tht �nsptrtor of 'Puilbings
212 Main Street•Municipal Building
Northampton, Mass. 01060 =-
#320
CERTIFICATE OF OCCUPANCY
January 10, 1989
Page No. 28 Plot _1 EP.
Building (Name) New Single Family Dwelling Address Lot#16A Sylvester Road
Owner Mark & Kathy LaValley Address 260 Acrebrook Drive, Flo
Applicant Charles Miller Const. Co. Address 908 Ryan Rd. , Florence
Use: 1st Residential Occupancy
2nd Residential Occupancy
3rd Occupancy _
4th Occupancy
Zone District RR
Required Inspections:
New Building X _ Existing Building
Elevator Electrical ` ''
Plumbing a� �� -�' S.D. Fire —
Building
w Other
9'oee'tx��
Inspector of l3todings