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USE
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To 6e completed 6y all applicants
Name Mailing address — Number, .rtrret, city, anrf .Stag ZIP code Tel. No.
Owner or
Lessee „
Builder's
2• T.r.�--C/�� L i c e n s e No.
Contractor
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 f applicant Address Application dote
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans By Notes
Fee Started y Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number By Permit or Approval Check Date Number B
Obtained Obtained 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 19 ug —
Building Fire Grading
Permit Fee $ . /J/�
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
TI
CITY OF NORTHAMPTON
• MASSACHUSETTS
OFFICE of the INSPECTOR of BUILDINGS
Page Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Appli nt t complete all items in sections: I, I1, III, IV, and IX. G
ZONING
I• AT (LOCATION) DISTRICT
LOCATION .) STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
H
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
1 ❑ New building Residential Nonresidential
2 Addition(If residential, enter number 12❑ One family 18 ❑ Amusement, recreational
of neu) housing units added, if any,
in Part D, 13) 1Two or more family — Enter 19 ❑ Church, other religious
��umber of units— — — --)� 20 ❑ Industrial
3,�<Alteration (See 2 above) ❑ 21 ❑ Parking garage
14 Transient hotel, motel,
4 ❑ Repair, replacement or dormitory — Enter number
22 ❑ Service station, repair garage
5 ❑ Wrecking (1/multifamily residential, of units ——————— — -i
enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional
Part D, 13) 16 Carport
24❑ Office, bank, professional
❑
6 ❑ Moving (relocation) 1 Other — Specify 25 ❑ Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
��nonprofit ivate (individual, corporation, � 28 ❑ Tanks, towers
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
_-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 .....................
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT $ D
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 Public or com p an y 48. Number of stories..............
31Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, base n pxfei I
32n Structural steel dimensions ... .'Lam.•
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other — Specify 42,$Z�ublic or private company 50. Total land area, sq. ft. ..........
43 ❑ Private (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........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 f Electricity 44 ❑ Yes 45 ❑ No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevator? 54. Number of Full..........
46 C1, Yes 47 ❑ No bathrooms
Partial........
INSPECTION RECORD
DATE NOTE PROGRESS - CRITICISMS AND REMARKS INSPECTOR
Dagartt of Bnildfug erections — FIELD COPY
212 Main Street � Q
BUILDING
Mrth,pt", Ma, 0106
PERMIT
12C - 63
DATE Ssvtwber 7* 19 82 PERMIT NO. 432
APPLICANT Juno Delaney ADDRESS 11 Cloverdale St.. Flo.
(NOJ (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO New stx=ture (�) STORY gA AM house DWELLING UNITS
(TYPE OF IMPROVEMENT) N0. (PROPOSED USE)
ZONING
AT (LOCATION) 911 Cloverdale D STR CT—URA(NO.) (STREET)
rn BETWEEN AND Ij
�o (CROSS STREET) (CROSS STREET) l++J
LOT f
n
SUBDIVISION LOT BLOCK SIZE 1J
, m
p BUILDING IS TO BE 11 FT. WIDE BY 22 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m i
p
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
f (TYPE)
OLL REMARKS: Add garden hQUAR t0 existing garage - concrete slab
AREA OR ESTIMATED COST $ 1_5DO FEE
MIT
VOLUME
Ij (CUBIC/SQUARE FEET)
OWNER john, 11me L UJTXX VirgtA-ta Delaney BUI40I �EPT. , f Y
ADDRESS 11 r1overdale Street, Florence, Ma 01060 BYJ -- .-
f I