23A-286 (32) DEPT. PILE COPY
iD
City of Northampton BUILDING
' 14asachusetts PERMIT VALIDATION
Office of the Inspector of Buildings 1,
DATE SIB 7( PERMIT NO. 423
APPLICANT P Ht s LJ S T" ADDRESS INC.) Nonot gckl $t. Flo IC oxTR'a LICENSE)
NUMBER OF
PERMIT TO DArjl tT Or1 (01 STORY DWELLING UNITS
—Y EMENTI (PROPOSE. uSEI
Z DNIRc GI
AT (LOCATION) � DISTRICT
X 0.1 IIT R EEiI
BETWEEN AND (CROSS STREET)
I CROBB E [TI
LOT
m SUBDIVISION r![ LOT_BLOCK SIZE
p BUILDING IS TO BE_ 26-FT. WIDE BY�IT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O /
i TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
F liv[I
a
O
Ii REMARKS: 1�
AREA DR $' 40,000 FEEMIT $ 120.00
VOLUME ESTIMATED COST
([UBI V BODUE IEE11
OWNER P rm� t{�T rp U .S.
n1Inc BUILDING DE
ADDRESS nk lat — BY
(Affidavit on reverse side of application to be completed by authorize agent of owner(
I hereby certify that the proposed work is authorized.by the owner of record
and I have been authorized by the owner to make this application as his
authorized agent. - - - -
SIGNATURE OF AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19_.
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