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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
—may
Name Mailing address — Number, street, city, and State ZIP code Tel. No
Owner or
Lessee
lQ % �� - 7 C��S� Builder's
(J d / Licens e No.
2.
Contractor /� C
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 J � Application date
�OG /vYlGd
D0 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
Q Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obta ned 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
II. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number ��
Building. Use Group
Permit issued �Q/ 6L 19 _
Building / 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 BUILD GS ,;t
Page 42— C Plot , APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
/•r^ // „— ZONING
n '
I• AT (LOCATION) ��( DISTRICT_ �
LOCATION '(N 0.) `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 New building Residential Nonresidential
2 1plAddition(If residential, enter number 12 One family 18 ❑ Amusement, recreational
of neu, 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 - )inter number
__----_ - 22 ❑ Service station, repair garage
5 ❑ Wrecking (1l multifamily residential, of units -�
enter number of units in building in 15 ❑#_*Garage 23 ❑ Hospital, institutional
Part D, 13) ❑
16 Carport 24 ❑ Office, bank, professional
6 L-� Moving (relocation)
17 ❑Other - Specify 25 ❑ Public utility
7 ❑ Foundation only / •�- (� 26 School, library, other educational
B. OWNERSHIP C�f T��1ti% /U �'rt S"'y/L 27 ❑ Stores, mercantile
8 C<Private (individual, corporation, / 26 ❑ Tanks, towers
nonprofit institution, etc.) �oiE 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,,,••••,•....... S/ 7~47 school, secondary school, college, parochial school, parking garage for
department store, rental office building, office building at industrial plant.
To be installed but riot included If use of existing building is being changed, enter proposed use.
in the above cost
a. Electrical.......................
b. Plumbing .......................
c. Heating, air conditioning..........
d. Other (elevator, etc.)............. /
11. TOTAL COST OF IMPROVEMENT $ ( ��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.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
30 L] Masonry (wall bearing) 40 ❑ Public or private company 48. Number of stories................
31 ❑ood frame 41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior /
32 Cj Structural steel dimensions .....................
33 [___1 Reinforced concrete
H. TYPE OF WATER SUPPLY
i 50. Total land area, sq. fT. ...........
34 E-1 Other 42 Public or private company Other - Specify �_�
43 Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed .......................
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 LIJ Gas Will there be central air 52. Outdoors........................
36 Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 LF Electricity 44 Yes 45 No 53. Number of bedrooms..............
38 Coal
39 F_ Other - Spcci6 Will there be an elevotor? Full..........
54. Number of
46 � Yes 47 I`� No bathrooms
Partial.......
_ 'xC`'i,_ r:!!: �".'_d?"^ Cf.!*MmM.3"F.^°x?!"+{+?s. -�mr ^ya'y� x 5f :RS"".. J�'Rw',, w., crve-� m^V�z.^.. ..em -- -.�..
'�� r
� t
w
enri
g, Pee
BUILDING 'z
Do-par f
North *a. 01060
ON*ut P�R a
12C g1t VALIDATION
DATE Tunis 2p 19 $1 PERMIT —
APPLICANT AD SS Ca .S�t s ►
�+ (NO.) `(STREET (t
APPLICANT R'S LICENSEI
NUMBER OF
PERMIT TO ( ) STORY DWELLING UNITS —
[TYPE OF IMPROVEMENT) NO. (R,ROP; ED U $)
A ZONING
AT (LOCATION) U4,6U nv4lta DISTRICT -A
(NO.) (fTRE T)
BETWEEN D
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LO BLOCK SIZE
Ad di SAX;UMS TO BE 1( FT. WIDE BY . ONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
Garage 20 2
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS:
foundation
AREA OR $ ���S� FEEMIT
ESTIMATED COST 48_00
VOLUME
(CUBIC/SQUARE FEET)
OWNER BUILDIN DEPT
ADDRESS 12 R d eL Driver 11 nra uc- X-0 (3106(6 BY `r
WHITE FILE COPY ■ GREEN ^ FIELD,-; COPY CANARY ^ APPLICANT COPY • PINK ASSESSORS COPY
OVA"
Department of Building Inspections
�2`MaimStreet BUILDING O° Z,
Northampton, Ma. 01060 PERMIT 2a
12Ci • 85 VALIDATION
DATE .111ne 2, 19 a1 PERMIT NO. 260
APPLICANT CceYard Ty Vail l annrnirt ADDRESS WoodmnctPr Tnc�� Rnx 195. Hookgptf N _
(NO.) (STREET) (CONTR'S 41 ENSE)
NUMBER OF
PERMIT TO Add (_t_) STORY DWELLING UNITS
(PRO 1
TYpE OF IMPROVEMENT) NO. P EO USE)
ZONING
AT (LOCATION) 12 Rick Drive DISTRICT IIRA
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
Addition
90DOI s�IS TO BE 10 FT. WIDE BY 14 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
Garage 20 24
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: F-r'nn standia.e- gAraae on g.rade beam m fovil.dation, addi Linn 4' r-rawl goAne
foundation
AREA OR PER MIT
VOLUME ESTIMATED COST $ 15.158 FEE
(CUBIC/SQUARE FEET)
OWNER 'F,4 r rd W. & Helen Sillaa
ADDRESS 0IL� BBVILDIN OEP
12—R�sk IIrive,—Florence, Ma.
WHITE - FILE COPY GREEN - FIELD COPY w CANARY - APPLICANT COPY • PINK - ASSESSORS COPY