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IDENTIFICATION — To be completed by all applicants IName Mailing address — Number, stmt, city, and State ZIP code [��Teell.. No. Owner or J2 S, S , C. ,! —�. e',/©6V — '. 6 — Lessee / Builder's 2, License No. Contractor Architect �C Architect or --- Engineer I hereby certify that the proposed work is authorized by the owner of record and that I hove 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 J I rp L)Q,D.I.e � ¢- 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 ate D Permit or Approval Check ObDta ned Number By Permit or Approval Check Obttat 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 VII. VALIDATION Building FOR DEPARTMENT USE ONLY Permit number Bui Iding Use Group Permit issued 11��V li.�A.'J,WA C_ ) 19 Building _yh Fire Grading Permit Fee $ Live Loading Certificate of Occupancy $ Occupancy Load Approved by: Drain Tile $ Plan Review Fee $ TITLE o CITY OF NORTHAMPTON MASSACHUSETTS OFFICE of the INSPECTOR of BUILDINGS Page Plot �1715_ APPLICATION FOR INSPECTOR ZONING PERMIT AND BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O ! /) y'�) ZONING SI AT (LOCATION) QS_ (^/ 7 S'!/ ��lyC� T�di��Tr(� DISTRICT LOCATION N0.) (STREET) rte OF BETWEEN � A- 0[�CIL AND SLih [TJ �! ct 12 GL- BUILDING ' (CROSS STREET) (CROSS STREET) V SUBDIVISION LOT BLOCK S�ZE X �Co '20 �X f j N II. TYPE AND COST OF BUILDING - A11 applicants complete Parts A - D A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m 1 New building Residential Nonresidential 2 ❑ Addition(It 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) 14 Transient hotel, motel, ❑ Repair, replacement - 21 r 1 Parking garage 4 p p or dormitory - Enter number 22 �_ � Service station, repair garage 5 ❑ Wrecking (If multifamily residential, of units ------- - enter number of units in building in 15 ❑) Garage 23 [_JI Hospital, institutional Part D, 13) 16 C CJ/arport 24 �❑ Office, bank, professional 6 ❑ Moving (relocation) � S � 17 ❑t/) OTher - Specify tok� _ 25 r Public utility 7 r❑ Foundation only 26 School, library, other educational B. OWNERSHIP t 27 Stores, mercantile 8 Private (individual, corporation, 28 C Tanks, towers nonprofit institution, etc.) 29 Other - .Specify 9 0 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................ bO 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....................... �J b. Plumbing ......... J too /c ji�islkl1! C",C: &/-c , c. Heating, air conditioning......... ; �� d. Other(elevator, etc.)............. 4u,&I USG �c°pd�k &Dcat .4 11. TOTAL COST OF IMPROVEMENT $ �cxoo � S 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. OF SEWAGE QISPOSAL J. DIMENSIONS N` 48. Number of stories................ E. PRINCIPAL TYPE OF FRAME G. TYPE 30�❑ MM sonry (wall bearing) 40 ' ! P.;blic or priva e company 31 �' Wood frame 41 Private (septic tank, etc.l 49. Total square feet of floor area, 5- -- all floors, based on exterior 32 L❑ Structural steel dimensions .................... L y 33 Reinforced concrete H. TYPE OF WAT%/XPLY G -- '��V/��/F�jf'� 50. Total land ores, s FT. 34 �� Other - Specify __ 42 Public or private company q' 43 Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed ....................... F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 35 Ej Gas Will there be central air 52. Outdoors........................ g? conditionin 36 D Oil L. RESIDENTIAL BUILDINGS ONLY 37 L j Electricity 44 Yes 45 No T 53. Number of bedrooms.............. 39 i✓1 ��J f Other - Specify �"QQ� Will there be an elevators Full.......... 54. Number of gfor('' - 46 r Yes 47 !r No bathrooms uCs `� ©C(/dSr'O�B� 1 ZSC., ). — Partial........ -OEPT.'OF BUILDING INSPECTIONS BUILDING z° + 212 Main Street Oa Northampton, MA 01060 PERMIT 28 - 25 VALIDATION November 2, 710 DATE 19 PE MIT NAr. APPLICANT dames Ussailis ADDRESS nnell `fir. , f orence Uwner (NO.) (STREET) (CONTR'3 LICENSE) New Building Storage Building NUMBER OF PERMIT TO g (_I STORY 9 e 9 DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) CIS AT (LOCATION) 24 O'Donnell Dr. , Florence DIOSTR 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 storage building to store equipment, tools and garden equip. . AREA OR 5,000.00 PERMIT 20.00 VOLUME ESTIMATED COST .$ FEE (CUBIC/SQUARE FEET) Same as Applicant OWNER BUILDI ADDRESS BY WHITE - FILE COPY . GREEN - FIELD COPY • CANARY • APPLICANT COPY • PINK - ASSESSORS COPY pw P MENNOW