43-074 (4) o
. DEPT. OF BUILDING INSPECTIONS
212 Main Street BUILDINGg/e) aaF�'�__ Northampton, MA 01060 PERMIT ."
VA LID AT10N
43 - 74 111.�^ 'C
DATE x---12 P
APPLICANT Gail & John Hayes �GtS un y riveERMIT NO. 406
ADDRESS Owners
(x0.) (STREET) (COMP'S LICENSE)
PERMIT TO Above Ground Pool I_I may FAmi ly DWELLINGNUMBER UNIS
I TTPE 01 IMPROVEMENT( NO. (PROPOSED USE)
AT (LOCATION) 128 Dunphy Drive ZONING SR
(NO.) (STREET) DISTRICT
BETWEEN AND
(CROSS STREET) (CROSS ITISMR)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPO
REMARKS: permit for the installation of an above ground nool 18' diameter
AREA OR PERMIT tym
VOLUME ESTIMATED COST $ 1 .100.00 FEE
S
I CUSIC/SOUARE FLIT)
OWNER Same as XXX Owners
BYILOIN
ADDRESS BY
WHITE - FILE COPY • GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY PP„
�j77..7i- i CITY OF NORTHAMPTON
MASSACHUSETTS
;Will r
t, • ; pl OFFICE of the INSPECTOR of BU LDINGS
�E.-"y+': Cipeg ES) Page 4-1,4 Lt3 Plot
_aYJres 8APPLICATION FOR
INSPECTOR LtN C J ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT - Applicant to complete all items in sections: I, II, III, IV, and IX. o
AT (LOCATION) lab 1:3uNPH 4 DR 1VE ZONING
GISMO
LOCATION LNO ' 1iPE
OF BETWEENOFF TTE , !o(, AND COL. —DE SAG
BUILDING (CROSS STREET/ ICRoss STREET)
SUBDIVISION LOT as BLOCK SIZE tis, a ato s (-
II. TYPE AND COST OF BUILDING - All applicants complete Parts A - D n
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking'. most recent use to
m
1 I I New building —iRsidemial Nonresidential
2I I Addition fl/ residential, enter number 12 ri one family IB L I Amusement, recreational
on new housing units added, if any, 131 I Two or more family — Enter 19 Church, other
inPart o s31 LJ religious
number of units————y 20 P-i Industrial
3 I I Alteration (See 2 above)
14 I I Transient hotel, motel,
A I I Repair, replacement r dormitory — Enter number21 ( Parking garage
5 Ll Wrecking (I/multifamily revidential, of units — y 22 ' I Service station, repair garage
enter number of antis in building in -
15 ' i Garage 23 I Hospital, institutional
Part O J31 16 ,I Carport 247 Office, bank, professional
6 ri Moving (relocation) y�
7 -1 Foundation only iJ I i Other — Specs/1 _
j Ij Public utility
26 I -. School, library, other educational
B. OWNERSHIP is J ABOVE GRQuu 0 n ' 1 Stores, mercantile
8 X Private (individual, corporation,
28 17] Tanks, towers
nonprofitinstitution, c.fa SuiI MM I NI CT POOL 29� mber - sperm,
,
9 ) I Public (Federal, State,or
local government/
C. COST (omi( cents) Nonresidential — Describe in detail proposed use of buildings,e.g., food
processing plan machineshop, laundry building at hospital, elementary
10. Cost of improvement $ ly Q( et.) school, secondary schoocollege , parochial school, parking garage for
deportment ,e, 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.
111°e aboveost
a. El tr al100,00
b. Plumbing
c, Heating, air conditioning
d. Other (elevator, etc 1
11. TOTAL COST OF IMPROVEMENT E I t I 06,00
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Pons E - L;
for wrecking, complete only Pan J, for all others skip to IV.
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
301 I Masonry (wall bearing) 40 L. Public or private company 48. Number of stories
31 F. Wood frame 41 Privote (septic tank, etc.) 49- Total square floorarea,ors
all
o . .o
r
33 LT Reinforced concrete1 H. TYPEqOF WATER SUPPLY
Ni34 rF Other — 1pecl/ it ROOMS) 42 til Public or s,ate company50. Total land area, sq. ft.
431, Private (wellcistern) K. NUMBER OF OFF-STREET
R&tvE GROUND PDoL PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL s). Enclosed
35 b Gas Will there be central air 52. Outdoors
36 �� Oil conditioning;
e _ L. RESIDENTIAL BUILDINGS ONLY
37 `_ Electricity 44 I; Yes 45 No
53 Number of bedrooms
38 i j 1 Coal
39� Other— epeci/y will there be an e'evotor1
{ Fan
54. Number of —
46 Ll Yes 47 7-i No bathrooms
Partial
IV. IDENTIFICATION - To be completed by oil applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
o:nera, SONNc, BGAuL Re tab -DuNPH ? TR . 5-89 -
L 14Ay'e5 NCCHI9nPTON, MA co/oho o/o% b5'n—
Budder s
2. License No.
Contractor
Architect or
3.
Engineer
I hereby certify that the proposed work is authorized by the owner of record and that I hove been authorized by the owner to
make this application as his authorized agent and we agree to conform to all applicable lows of this jurisdiction.
Signature of applicant Address o' ^ /iriar Application dote
,'Q Ce yIm lair 72.-es./0.49_ 6QL , -teG/oho 6/a �87
v DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD - For office use
Plans Review Required Check Plan Review Dote Plans ByDate Plans By Notes
quire Fee StartedApproved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or ApproveI Check Dote Number ByPermit or Approval Check Date Number By
Obtote Pprova Obtained y
•
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 i
VII. VALIDATION
Building / ` FOR DEPARTMENT USE ONLY
Permit number Y f(`°
BuildingC .75- 19 �,-} Use Group
Permit issued
Building / /`q Fire trading
Permit Fee $ '/ �Q ' Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by: avanpafJ .04;24.Drain Tile $
Plan Review Fee $
TITLE
NOTES and Data — (For department use)
VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
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