07-007 (2) DEPT. FILE COPY
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�DHPARa�7T OF BUILDING INSPECTIONS BUILDING
vz STREET PERMIT
N0f2TRdFLPTONs NA. 01060 vA LIBATION
7 - 7
DATE Anrii. 25, 505 No.
PERMIT NO. 148
APPLICANT Phillip R Kelley ADDRESSNo. PATOIS! RA Salton_
(No.) (STREET) ICONTR's LICENSE)
NUMBER OF
PERMIT TO Addition to Saeid. 1 i I STORY Addition DWELLING UNITS i
(TYIE OF IMPROVEMENT) KO. )PROPOSED OSE)
AT (LOCATION) *70 North Farms Road DIS,TR CT ING RE
(No.) (STREET)
EE BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
® SUBDIVISION LOT BLOCK SIZE
a MEW
O dMBMIET Is TO BE 9 FT. WIDE BY 29 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
z )TYPE)
B
li REMARKS: Addition pen anaingnd slostah `nee igplient.inn,AREAp/y� $
VOLUME ESTIMATED COST $ 1500.00 FEEMIT
10.00
I EYBIC/SOVARE FEET)
y1
OWNER *70 North Plano Road q /q�?/ (
ADDRESS Northampton. Ma Ai(IFitf avILDIVE-rA - 'a
(Affidavit on reverse side of application to be completed by authorized agent of owner)
I hereby certify that the proposed work is authorized by the ownef of record
and I have been authorized by the owner to make this application 'as kis
authorized agent.
SIGNATURE bE AGENT
ADDRESS
(NUMBER) (STREET)
APPROVED BY TITLE
DATE 19-.
( ,. .,
•
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060
7- PLAN EXAMINATION AND
BUILDING PERMIT
IMPORTANT - Applicant to complete all items in sections:)I, II, HI,/ IV, and IX. 77
AT (LOCATION) "T 7J NJPT� �/� l"✓)1 s I\/I f�r'L DISTRICT p/`
LOCATION 'ST
OF BETWEEN AND
BUILDING )CRass STREET) {CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
in
II. TYPE AND COST OF BUILDING - All applicants complete Parts A - D -4
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking” most recent use Tn
-1
1 New building ~
Residential Nonresidential
2 N Addition(If residential, enter number 12 LXI One family 18 raI Amusement, recreational
in new housing units added, if any, 13 Two or more family - Enter 19 Church, other religious
Part 13) LJ
number of units- - - --i 20 I Industrial
3 I I Alteration (See 2 above) 14 I Transient hotel, motel, 21 I Parking garage
4I Repair, replacement or dormitory - Enter number
5 Ti Wrecking (If multzfwnily residential. of units - y 22 Service station, repair garage
enter number of units in building in 15 I I Garage 23 I Hospital, institutional
Part D, 13)
16 71 Carport24 I Office, bank, professional
6 I I Moving (relocation)
7 Foundation only 17 I I other - Specify 25 I Public utility
26 _J School, library, other educational
B. OWNERSHIPWN27 L Stores, mercantile
B I � Private (individual, corporation, 28 ,L Tanks, towers
nonprofit institution, etc.) _ 29 I Other - Spec ifY
9 I I 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 $ /� iT pr), ,np school, secondary school, college, parochial school, parking garage for,
deportment store, rental office building, office building of 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 E ./ -T c —
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 L J Masonry (wall bearing) 40 I Public or private company 48. Number of stories
31 Wood frame Al Private (septicrank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 Structural steel dimensions ..9.AC.9.,9
33 Reinforced concrete H. TYPE OF WATER SUPPLY
34 Li Other - Specify 42[31 Public or private company 50. Total land area, sq. ft
431 I Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed
35 KI Gas Will there be central air 52. Outdoors
36 7 Oil conditioning?
37 Electricity 441 Yes 45 . J Na L. RESIDENTIAL BUILDINGS ONLY
53. Number of bedrooms
36 I Coal
39 I Other- Specify Will there be an elevator? l Full
�
54. Number of
46 1 Yes 47 I3V1 No bathrooms
Partial
NOTES and Data — (For deportment use)
•
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — ,Number, street, ray, and ,State ZIP code Tel. No.
goner or th t.p 7(2 KtL14 SO 5' NOrTit fgrm l70/)d—N-i1nn�+Tot,I 8O96 /1
Lessee 0/C40
2. LU«nse No.
Contractor ........
Architect m—.....„ ........ -._
Engineer
certifyproposed work is authorized by the owner of record and that I hove been authorized herebythat the o by the owner to
make this application as his authorized agent and we agree to conform to all applicable laws of this ju isdiction.
Si notere a eppiicont Address Application dote
5. d
o5 /�'or74 Arms fron .
r/1/27
DO NOT WRITE BELOW THIS LINE
V, PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plops
quire Fee Started By Approved y Notes
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $ �.
OTHER $ _
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Da
Permit or Approval Check Obta ned Namber By Permit or Approval Cheek O'D,°'ined 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,
VII. VALIDATION
Building / . FOR DEPARTMENT USE ONLY
Permit number
Building
Use Group
Permit issued � T1� ,L 19
Fire Grodmg
Building 6;
Permit Fee $ - — Live Loading
Certificate of Occupancy $ Occupancy toad
Approved by:
Drain Tiie $_
i , f ,
Plan Review Fee /$ j
j
ti TI _LEet'�
4 _
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YIN. ZONING PLAN
EXAMINERS
NOTES ' '
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