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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants *0 ft
Name Mailing address — Number, stmt, city, and State ZIP code Tel. No.
Owner or
'V
Lessee 7
Builder's O �p
2. 02 r aFV'e �, . — 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 appl'c nt Address p Application date
DO 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
9 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL Is
OTHER Is
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
VII. VALIDATION
Building /'� FOR DEPARTMENT USE ONLY
Permit number (�
Building n '�.., Use Group
Permit issued 1 W C} a 193
Building
Fire Grading
Permit Fee $ �D 'e�)
Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by: /
Drain Tile
4�
Plan Review Fee $ '
TITLE
G .
CITY OF NORTHAMPTON
MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
A
Plot SO
Page APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, I1, III, IV, and IX. 0
' r ZONING
AT (LOCATION) � /b.t' DISTRICT
LOCATION IN 0.) STREET)
OF BETWEEN AND
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 rn
rn
1 D New building Residential 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— — — — 20 �� Industrial
3 X] Alteration (.See 2 above)
14 _ Transient hotel, motel, 21 [_�
Parking garage
4 7 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 L Garage 23 C Hospital, institutional
Part D, 13)
16 �� Carport 24 LA Office, bank, professional
6 n Moving (relocation)
17 [� Other — Specify 25 Public utility
7 Foundation only
26 � � School, library, other educational
B. OWNERSHIP 27 Stores, mercantile
8 Private (individual, corporation, 28 � � Tanks, towers
nonprofit institution, etc.) 29 Other — Specify
9 n 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 charsged, enter proposed use.
in the above cost
a. Electrical.......................
b. Plumbing ......................
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT I$ '
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 W.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
30 �J Masonry (wall bearing) 40 � Public or private company 48. Number of stories..............
49. Total square feet of floor area,
31 Wood frame 41 Private (septic tank, etc.) ,^(1/
all floors, based on exterior V 7
32 L� Structural steel dimensions .....................
33 E� 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
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 L] Electricity 44 Yes 45 ', No 53. Number of bedrooms..............
38 F] Coal
39 L7—] Other — Specify Will there be an elevators Full..........
54. Number of
46 [_-1 Yes 47 'D No bathrooms
Partial.......
City of Northampton REQUIRED INSPECTIONS
1 . Footings and Walls
BUILDING DEPARTMENT 2 Structural Components in
Place
3. Complete Building
No. 840 Office of the Building Inspector
Date November 21 , 19 89
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BUILDING PERMIT
THIS MAY CERTIFY THAT C & C Contractors Insp. on Site — Foundations
has permission to add onto existing sun room 6' X 8' Insp. of Plumbing — Rough
situated on 453 Audubon Road 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,
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.)
t
Inspectors.
Gas Inspection
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON THE PREMISES
Certificate of Occupancy
ild ng nspec
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