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NOTES and Data — (For department use)
(tWNp
04' TO
� � J�lisssacltasetts
�., DEPARTMENT OF BUILVDT G INSPECTIONS
F
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
AS A HOMEOWNER I UNDERSTAND THAT I MAY APPLY FOR AND RECEIVE
A BUILDING PERMIT FOR A HOME OR ADDITION I INTEND TO LIVE IN.
I ALSO UNDERSTAND THAT I AM RESPONSIBLE FOR KNOWING THE STATE
BUILDING CODE AND ZONING ORDINANCE OF THE CITY OF NORTHAMPTON.
BEING A HOMEOWINER AND NOT A PROFESSIONAL CONTRACTOR IN NO WAY
ABSOLVES ME OF ANY RESPONSIBILITY TO INSURE THAT ALL FACETS
OF THE RULES AND REGULATIONS ARE COMPLIED WI
IV. IDENTIFICATION - To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
1 2K � �b4 N S -5916 -
Owner or
Lessee C,C-CO&M IcK ��pfG b 1Obd � b
Builder's
2. License 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 of applicant Address Application date
e'77 I-
If
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 $
V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number By Permit or Approval Check Date Number 8
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 0�/� FOR DEPARTMENT USE ONLY
Permit number #
Building Use Group
Permit issued 1 Ia1 19 S'9 _
Building Fire Grading
Permit Fee $ 1 .
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $
ITLE
CITY OF NORTHAMPTON
�. MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
Page Plot APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. C)
ZONING
/� Qp / ��// /J
I• AT (LOCATION) 1..�dgxoe—Yx> T �lh DISTRICT
LOCATION ) (NO') (STREET) ///�
OF BETWEEN 100 )6)0171 S AND &9& / fi�Gl�•
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 Addition(I/ 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 n 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 C j Garage 23 Hospital, institutional
Part D, 13) r
16 Carport 24 I� Office, bank, professional
6 Moving (relocation) ,�'yy'' s�
17 � Other — Speci/y frt��r r�� 25�� Public utility
7 Foundation only 26 School, library, other educational
B. OWNERSHIP 27 C Stores, mercantile
8 Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 F-1 Other — Specify
9 Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food
j � processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,,,,,,•...,... V 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 $
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 p�
30 ❑ Masonry (wall bearing) 40 Public or private company 48. Number of stories...............
31 Wood frame 41 Private (septic tank, etc.) 49• Total square Feet of floor area,
all floors, based on exterior
32 Structural steel dimensions ..........I..........
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 Other — Specify 42 Public or private company 50. Total land area, sq. f+. ........... jJ PTA 1}
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........................ 3
36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 E Electricity 44 Yes 45 _�7i No
. 53. Number of bedrooms..............
3B E Coal
39 FL--] Other — Specify Will there be an elevotoO 54. Number ull..........
ber of
46 r � Yes 47 ? No bathrooms
Partial.......
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�. .e City of Northampton REQUIRED INSPECTIONS
1 . Footings and Walls
BUILDING DEPARTMENT 2 . Structural Components in
Place
3 . Complete Building
No. 844 Office of the Building Inspector
6 - 0 /7 1 Date November 27, 19 89
BUI DING P RMIT
THIS MAY CERTIFY THAT Mark & Martha McCormick Insp. on Site — Foundations
has permission to add dormer onto single family dwelling Insp. of Plumbing — Rough
situated on 34 Carolyn St. , Florence Insp. of Plumbing — Finish
provided that the person accepting this permit shall in every re- Insp. of Wiring — Rough
spect conform to the terms of the application on file in this office, ,Q� ��fs--
and to the provisions of the Statutes and the Ordinances relating Insp. of Wiring — Finish
to the Construction, Maintenance and Inspection of Buildings in Insp. of Health (Septic Tanks)
the City of Northampton. Any violation of any of the terms above
noted is an immediate revocation of this permit. Expires six Building Insp. — Rough
months from date. Building Insp. — Finish
Note: A certificate of occupancy will be issued by this office upon
return of this card signed by the Plumbing, Wiring and Building Smoke Detectors (Fire Dept.)
Inspectors. Gas Inspection
THIS CARD MUST BE DISPLAYED IN O SPICUOUS PLACE ON THE PREMISES
Certificate of Occupancy —
Building Inspector Yftk
i PRINT SHOP