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NOTES and Data — (For department use)
r
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
Owner or � 4 dayie
Lessee J.— I
r
2 Builder's t.'I
SS1— S ! License No.
Contractor
C` �' "l t
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.
Sign:26 pplicant Address Application date
� C"-0- k .P _7
I
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 Obtta t 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
Building `� ^,� Use Group
Permit issued t _ 19
Building ! .r/? Fire Grading
Permit Fee $ / U
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $ c�
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
g. g MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
Page ❑ Plot �41 APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
• P,- ZONING
`
I• AT (LOCATION) o C DISTRICT _
LOCATION No.1 (STREET)
._J
OF BETWEEN Cl Pl -V_. 1 rr AND k(4
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
V1
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
-a
1 ❑ New building Residential Nonresidential
2 Addition(If residential, enter number
12 7� 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, 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 — SpeciJy 25 Public utility
7 ❑ Foundation only
26 School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8 54 Private (individual, corporation, 28❑ Tanks, towers
nonprofit institution, etc.) 29❑ Other — Specify
90 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,,,,,,,,,,•..... ADO 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....................... dC�
b. Plumbing .....................
c. Heating, air conditioning.......... SQo
d. Other(elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT is
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 LX Public or private company 48. Number of stories................
31 Wood frame 41 El Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 Structurol steel dimensions ..................... �. Q
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
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 F1 Yes 45 Y No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will there be on elevators 54. Number ull..........
ber of
46 [-1 Yes 47 YJ No bathrooms
Portia(.......
J h
DEPT. OF BUILDING INSPECTIONS BUILDING Z°
212 Main Street 0
Northampton, MA 01060 PERMIT <a
28 - 49 VALIDATION
DATE XD4 April 3, 19 89 PERM T N 195
APPLICANT CmSSroAdg Cnnstru tion ADDRESS 178 Nortnest Ra. , files amp on 2366
.
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO llterativn (-) STORY One Family DWELLING UNITS
TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) u rat i l l anP Terr DISTRICT Sys I�
(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
lrrPEl
REMARKS, permit for misc. alterations to single family dwelling
AREA OR ESTIMATED COST $ 3,800.00 FEEMIT $ 16.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER Daniel & Suzanne Edwards
ADDRESS ahillane Terr. , Florence BYI
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY P'AM% P