43-068 (3) r.
') DEPT:OF 212 Main WILDING INSPECTIONS BUILDING ;_ beE�.I-Y- Northampton,SMA 01060 PERMIT :
1Pa�e CITY OF NORTHAMPTON
MASSACHUSETTS
"th°=,� ea . OFFICE of the INSPECTOR of BUILDINGS we _.P �(
tc.,07,75&-0
,,= � Page "7r Plot (OS APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
IMPORTANTRy�� - Applicant to complete all items in sections: I, II, III, IV, and IX. O
eel DV r Pix VicVtif- ZONING qui
AT {LOCATION) _ GiSTNICTc .Y\
LOCATION NO.] ISTIEETI
OF BETWEEN g?C 6l, - AND 1 4) • 041%�
BUILDING (CROSS STRLET1 (CROSS STREET]
LOT
SUBDIVISION LOT BLOCK SIZE
IA
II. TYPE AND COST OF BUILDING - All applicants complete Parts A - D -d
A
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"wrecking" most recent use I^
rn
1 I_ New building Res
iddgf A_ al l Nonresidential`Js -I2r-1 Addition(If residential, enter number 12 rt One rami ly IB Amusement, recreational
of new honk Tap units added, i/any.in 13
Two or more Family
t- oter 19 Church, other religious
Part D, 13) 1 number or unit's y 20 Industrial
- ❑ giaus
3 Alrerali on (See 2 above)
141 Transient hotel, motel, 21 �FH
Parking garage E l Repair, replacement or dormitory - Enter numb
6 El Wrecking (if multifamilyresidential. o/ — � 22L Serystation,
, repair garageParr nmober of untts is building in 15 [ j Garage 23 r ; Hospital,
institutional
Part 0. 13)
16 rl Carport 241 1 Office, bank, professionol
671 Moving (relocation)
7 Li Foundation only 17 LI Other -Spea-i/y 25 LIPublic utility
26 LI School, library, other educational
B, OWNERSHIP 27 E H Stores, mercantile
8 Private (individual, corporation, 20 Tanks, towers
nonprofitinstitution, etc.) 29 LJ Other Specify
9 ❑ Public (Federal, State, or
local government)
C. COST (Omit renes) Nonresidential - Describe in detail proposed use of buildings, e.g., food
processing pc fo
plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement S ',iO school,
secondary school, college, parochial school, parking garage r
departmentstorat
rental office building. office building industrial plant.
To be installed but not included It usof existing building is being changed, enter proposed use.
in the above cost
a. Electrical
b. Plumb g
c. Heating, an conditioning
d. Other (elevator, etc i
-- - - -- -
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
301 I Masonry (wall bearing) 40 J yPublic or private company 46_ Number of stories
31 Wood frame 41 Ir'TI Private (septictank, etc.) 49, Total square feet of floor area,
all floors, based on exterior
321 I Structural steel —/ dimensions
331P1 Reinforced concrete H. TYP yOF WATER SUPPLY
34 1 j Other — Spec-i/y 42 1 + Public or private co a y 50. Total land area sq. Ir
431 I Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed
351 L1 Gas Will there be central air 52. Outdoors
36 '_] Oil conditioning' L. RESIDENTIAL BUILDINGS ONLY
37 r_i Electricity 44 n__ Yes 45 JNo 53. Number of bedroom
38 L Coal lll
39 L-1 Other- Triunity will there be on elevatorp� 54. Numberat Fun
46 [_ I Yes 47 I No bathrooms
Partici
IV. IDENTIFICATION - To be completed by all applicants
Name teMailing address — ,Num her, street, city, and State ZIP code TO. No.
owner or (ANC,A Sps 2 ) OJtuck( fThUZ
Lessee /��� �'.,...
z Letn .� kA31(611 � II6 iC/R (t,IJ ��VLBudder No.
Contractor
0194
1( sibs
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 authori ,• 'agent and we agree to conform to all applicable lows of this jurisdiction.
Signature of a..li cant Address Application date
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIE RECORD - For office use
Plan Review Date Plans
Plans Review Required Check Fee Started aBy Dote Approved By Notes
teolan
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
e 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
BuildingI (09FOR DEPARTMENT USE ONLY
Permit number
BuildingF. Use Group
Permit issued \ 1 c)/14. G1/l19
Building 1� Fire Grading
Permit Fee $ )l'TY) - Live Loading
Certificate of Occupancy $ Occupancy Load
$ APprov by: a £ it
Drain Tile 4✓I�f.�,Q- ./(,yl
Plan Review Fee $ r/J� l
TITLE
NOTES and Oath — (For department use)
1
1
VIII, ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIOE YARD
REAR YARD
NOTES
IEi. SITE OR PLOT PLAN - For Applicant Use
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Linda Shea
80 Dunphy Drive
Northampton, Ma 01060
April 7, 1987
To Whom It May Concern,
Louis Montgomery, Inc. , is doing some remodeling work in my basement. The
rooms are not to be used as bedrooms but only as additional storage and study
rooms and a television room.
Linda M. Shea
144C 10 ,
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