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DISTRICT
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SIDE
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and .Stale ZIP cod Tel. No.
I.
owner Or
Lessee
2 _ Builder's
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.
at of applicant Address 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
Fee Started y Approved By Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number B Permit or A Date
Obtained Y Approval Chec 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 _ &6
Building. Use Group
Permit issued - 19"
Building Fire Grading
Permit Fee $ ec.0d
Live Loading
Certificate of Occupancy $ Occupancy Load
Appro by:
Drain Tile
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
ge ';� MASSACHUSETTS
$ e OFFICE of the INSPECTOR of BUILDINGS
IY T
Page /7C' Plot �7� APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, II, 111, IV, and IX. 0
ZONING n
I• AT (LOCATION) �� DISTRIC /`
LOCATION (NO.) Nr (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
M
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
1 ❑ New building Residential Nonresidential
2❑ Addition(IJ 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— — — — -i 20❑ Industrial
3 ❑ Alteration (See 2 above) 14 Transient hotel, motel,
❑ 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 El Wrecking (1l multifamily residential,
of units ——————— — -� 22 ❑ Service station, repair garage
enter number of units in building in 15 INX Garage 23 ❑ Hospital, institutional
Part D, 13) 16 n Carport 24❑ Office, bank, professional
6 ❑ Moving (relocation) 25❑ Public utility
17 ❑ Other — Specify
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 ❑ Public(Federal, State, or
local government)
C. COST (Omit cents) Nonresidential — Describe in detoil proposed use of buildings, e.g., food
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement••,•••,....••... C?.. 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
a. Electrical..................... ♦ lt. »rU lT/�J /1 Zef�'� ,/
b. Plumbing .....................
c. Heating, air conditioning.........
d. Other (elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT S to ou
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...............
31 ❑ Wood frame 41 ❑ Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior
32 ❑ Structural steel dimensions .....................
33 ❑ 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 ❑ Electricity 44 ❑ Yes 45 I':�] Na 53. Number of bedrooms..............
38 ❑ Cool
39 ❑ Other — Specify Will there be an elevator? 54. Number of Full..........
46 ❑ Yes 47 ❑ No bathrooms Partial
I..
DEPT. OF BUILDING INSPECTIONS BUILDING ZO
! 212 Main Street O<
Northampton, MA 01060 PERMIT <
17C - 274 VALIDATION
D T November 14, 19 85 PERMIT NO. 657
APPLICANT Harvey ADDRESS 23 Lilly LSt., Florence nwnPY'
(NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF
PERMIT TO New Building (_) STORY Dpt-,g _hr��[,�r LaTa DWELLING UNITS
(TYPE OF IMPROV ENT) NO. (PROPOSED USET
AT (LOCATION)
23 Lilly Street, Florence ZONING CT URB
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE 14 FT. WIDE BY 24 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: �
permit for the construction of a MX detached garage
AREA OR 336 sq. ft. ESTIMATED COST $ 1,000.00 FEEMIT s 10.00
VOLUME
(CUBIC/SQUARE FEET)
OWNER Harvey LaBarge
23 Lilly Street, Florence BYILD� EP�Ts �
ADDRESS P—1 ' XA`�-�6��+
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WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY ■ PINK - ASSESSORS COPY 0.1p