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IDENTIFICATION — To be completed by all applicants Name Mailing address Number, street, city, and State- ZIP code Tel. No. Owner or LlsSle 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 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 $ VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Date D Permit or Approval Check 06tta ned Number By Permit or Approval Check a Obtt t ed 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 Building 1/7. _� / Use Group Permit issued ;t t� CC 19 -� Building y L i �y Fire Grading Permit Fee $ s f 't. Live Loading Certificate of Occupancy $ Occupancy Load Approved by: Drain Tile $ Plan Review Fee $ TITLE CITY OF NORTHAMPTON MASSACHUSETTS $ OFFICE of the INSPECTOR of BUILDINGS Page Plot APPLICATION FOR INSPECTOR ZONING PERMIT AND BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O I. 1� l 41. ZONING � AT (LOCATION) DISTRIC T LOCATION (N0.) (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 >a A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m M 1 0 New building Residential Nonresidential 2 ❑ Addition(1/ 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 ❑ Alteration (See 2 above) 14 ❑ Transient hotel, motel, 21 ❑ Parking garage 4 ❑ Repair, replacement or dormitory — Enter number 5 ❑ Wrecking (II multifamily residential, of units ——————— — --> 22 ❑ Service station, repair garage enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional Part D, 13) 6 ❑ Moving (relocation) 16 ❑ Carport 24 E] Office, bank, professional 17 F__1 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 ❑ 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,,,,,,,,,,,,,,,, S 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 30F] 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 ..................... -E 33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY 34 ❑ Other — Specify 427/ Public or private company 50. Total land area, sq. ft. ........... 1 43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ....................... 35 ❑ Gas Will there be central air 52. Outdoors........................ 36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37 Ej Electricity 44 Yes 45 ', No ❑ -- 53. Number of bedrooms.............. a 33 ❑ Coal 39 ❑ Other — Specify H . + ,J JIf ': Will there be an elevators Full.......... 54. Number of 46 ❑ Yes 47 ❑ No bathrooms Partial........ a DErr. OF BUILDING INSPECTIONS BUILDING Z D -7 ! 212 Main Street $IL ` ct Northampton, MA 01060 PERMIT 49 - 8B VALIDATION DATE March 5 g 85 ER IT NO. 100 APPLICANT Leonard Brakey ADDRESS en e oaf (NO.) (STREET) (CONTR'S LICENSE) PERMIT TO New Building (_) STORY One Family Home DWELLING UNITS 1 (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) c AT (LOCATION) Lot #8B Glendale Roa ZONING CT SR (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 SMALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: permit for the construciton of a new one family home with the garage underneath VOLUME 960 s . ft. each floor ESTIMATED COST $ 59 700.00 PERMIT 597.00 (CUBIC/SQUARE FEET) OWNER Same as Applicant ADDRESS Same as Applicants BYI;i; - WHITE - FILE COPY . GREEN - FIELD COPY • CANARY ^ APPLICANT COPY • PINK A SESSORS COPY p}NT- P of Worthumptan Offirt of tht )nsptrtor of jAnilbingf. 212 Main Street•Municipal Building Northampton. Mass. 01060 CERTI C TE OF OCCUPANCY Page No. 49 Plot L '�- C, Building (Name) 12 6:"AAW4r: Address j' R Owner Address 346 Applicant Address Use: 1st Occupancy S 2nd AS idential Occupancy 3rd Occupancy 4th Occupancy R Zone District S Required Inspections: New Building X Existing Building Elevator Electrical", Plumbing Fire V GAS— Building Other All Inspector of BujWIngs