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NOTES and Data — (For department use)
Ff c
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or
Lessee
License No.Builder's 0
2 W•�• V •�_ V
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 of applicant Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Re wired Check Plan Review Date Plans By Date Plans B y Notes
Q Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obtained 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 = ' "
Bui Iding. \ /�' Use Group
Permit issued C �' !y1�Q?�.'L \ I 19
`
Building Fire Grading
1 ( , t D
Permit Fee $ *� Live Loading
Certificate of Occupancy $ Occupancy Load
A o by:
Drain Tile $
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
g• .� MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
, , Page 0 Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and 1X. O
1• AT (LOCATION) J"' ZONING DISTRICT!A e. --4
LOCATION (NO.) (STREET)
Ct
OF BETWEEN __ MIME�E J` ' AND
BUILDING (CROSS STREET) (CROSS STREET) dry f
LOT SUBDIVISION LOT 5V BLOCK SIZE— 1
N
11. 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 I<New building sidential Nonresidential
2 Addition(If 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— — — — -•o. 20❑ Industrial
3 ❑ Alteration (See 2 above) 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 Garage 23 ❑ Hospital, institutional
Part D, 13) 1 ❑ carport 24 Office, Bonk, professional
6 ❑ Moving (relocation) p
17❑ Other — Specify 25❑ Public utility
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP 27 ❑ Stores, mercantile
8 t5< 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
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement•,,,,,•,,,,,,,,• SYD,OCO 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 $US
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 private company 48• Number of stories................
Total square feet of floor area,
31 Wood frame 41 Private (septic tank, etc.) 49. all floors, based on exterior
32 Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
50. Total land ores, sq. ft. ... `I
34F__1 Other — Specify 42 �Public or private company """" 1
43 ❑ Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES n
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ....................... !/
35'�Gos Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 L❑ Yes 45)<�No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevator" Full........
54. Number of
46 ❑ Yes 47)<�No bathrooms
Partial
o� o Ct� of 'Nort4sulptott
� " � �Iassxchusetts -
f Offirt of tot �nsptstor of 'Pnilbings ,
212 Main Street•Municipal Building
Northampton,Mass. 01060
x'#663
CERTIFICATE OF OCCUPANCY
May 12, 1985
Page No. 17A Plot 304
Building (Name) New Single Family Dwelling/Gsrage Address Lot #52 Hillerest Drive
Owner Karen & Kip Lpnt (F,-- 21 Par!?. St. EAstt aton
�' Address �
Applicant W.S. Hall, Tm- . Address P.O. Fes' 511, kiierst
Use: 1st Residential Occupancy
2nd Resiedential Occupancy
3rd Occupancy
4th Occupancy
Zone District URA
Required Inspections:
t
New Building X Existing Building
Elevator Electrical j
Plumbin Fit Fire
t Gas: Q�
Building
Other
inspector of Bulliblingi
s a DEPT. OF BUILDING INSPECTIONS BUILDING °-
± 212 Main Street CA
Northampton, MA 01060 PERMIT
_. VALIDATION
DATE '^' (' `+ 19�„_,__� PERMIT NQ.
APPLICANT - - "� " ADDRESS.
�ANOY b (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO (_) STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
ZONING
AT (LOCATION) - DISTRICT
(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:
AREA OR . n PERMIT
VOLUME ESTIMATED COST $ FEE $ R
(CUBIC/SQUARE FEET)
.'v k�
UIL
OWNER `
ADDRESS BY <
v
WHITE - FILE COPY GREEN - FIELD COPY CANARY APPLICANT COPY PINK - ASSESSORS COPY p 0--fP