24A-009 (3) DEFT. OF'�UILDING INSPECTIONS Z / �
� � BUILDING ,
�,rl! 212 Main Street 0a
Northampton, MA 01060 PERMIT
24A - 9 VALIDATION
DATE April 29, 19 85 PERMIT NO. 213
APPLICANT Gerald R. Archambault ADDRESS 171 West St. , West Hatfield USN 010788
(NO.) (STREET) (CONTR'S LICENSE)
OF
PERMIT TO Alterations (_) STORY One Family DWELLLRING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION)
61 Terrace Lane ZONING
DISTRICT URg
(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 SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: Alterations to bath, install sky XXXXXIXXXXXIAX lite, install sliding glass door
off of breezway
VAREA OR
OLUME ESTIMATED COST $ 3,400.00 FEEMIT $ 10.00
(CUBIC/SQUARE FEET)
OWNER Daivd & Sandra Koch an I 7
61 Terrace Lane, Northampton, Mass. 01060 BUIL'' i�'fi r-iie lC
ADDRESSBY
WHITE - FILE COPY • GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pod 11P
• • j.i; . N1,, CITY OF NORTHAMPTON
VIII. ZONING PLAN EXAMINERS NOTES B MASSACHUSETTS
• �- Aim-,,. )6,1r1 '
$�' •,�..I+' t . OFFICE of the INSPECTOR of BUILDINGS
* -s•I 40 .
DISTRICT �-
-_ Page �`�A Plot 9 APPLICATION FOR
USE INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
FRONT YARD
IMPORTANT — Applicant to complete all items in sections: I, II, Ill, IV, and IX. O
SIDE YARD SIDE YARDZONING /770,
7 L_
I. AT (LOCATION) F' I I c2i 214CL L fl IOC DISTRICT /,
REAR YARD LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
NOTES
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D —I
73
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
—I
1 I New building Residential Nonresidential
2 Additionresidential, enter number
I (If 12 IYI One family 18 n Amusement, recreational
of new housing units added, if any,
in Part D. 13) 13 I Two or more family — Enter 19 I I Church, other religious
IX. SITE OR PLOT PLAN — For Applicant Use number of units— — — — —> 20 I I Industrial
3 f54 Alteration (See 2 above) 14 I I Transient hotel, motel,
4 I I Repair, replacement or dormitory — Enter number 21 I I Pocking garage
_ 5 ofunits — —� 22 I I Service station, repair garage
I I Wrecking (I f multifamily residential,
■ : enter number of units in building in 15 I Garage 23 pi Hospital, institutional
N Part D, 13) 16 I Carport 24 Office, bank, professional
6 I I Moving (relocation)
: 17 I I Other — Specify 25 u Public utility
r•raraa. :urarsrsaasrug 7 I Foundation only 26 I I School, library, other educational
:::_ g : B. OWNERSHIP 27 I Stores, mercantile
_ 54 28 I I Tanks, towers
amesoes.g _ _ 8 Private (individual, corporation,
nonprofit institution, etc.) 29 I Other — Specify
_ 9 I I Public (Federal, State, or
:••: : arcs local government)
•
rg cents)
C. COST (Omit
U. Nonresidential — Describe in detail proposed use of buildings, e.g., food
: _ : processing plant, machine shop, laundry building at hospital, elementary
: ei 10. Cost of improvement $ �)000 school, secondary school, college, parochial school, parking garage for,
rng department store, rental office building, office building at industrial plant.
:_ : g :r: To be installed but not included If use of existing building is being changed, enter proposed use.
":::_ in the above cost
men :
:::::oarrr. : : :: a. Electrical
a411.1•114111110111111111411:48 440)al
....aaa.a.. a.....: : : ii b. Plumbing t 4 o C�
Inaa.__aa..aa_ graaig c. Heating, air conditioning
a..F,P.— rm.-win : :: d. Other (elevator, etc.)
=::=gasnosxoua:s:asr•�i:•i::::::::: g : : : ..., 11. TOTAL COST OF IMPROVEMENT $ (.4 p Ct
:a:a::a..ar.........a...i r..sa... a::::::::.r...:: : : : :as..
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
:a::::::•...g ==ggggg =gg„g:S••:"•:•: : Mg :•� :: ga...:.g for wrecking, complete only Part J, for all others skip to IV.
:u::sass::::a : :• p■
aa:: sass ggggggg�gggg�g : : g ggg g E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS
a::al::::firi:::::: sr.eeseee •s :
aa•r. • .w.• r..• .i . : ggg : 30 I I Masonry (wall bearing) 40 I Public or private company 48. Number of stories
•..... •• • r. 49. Total square feet of floor area,
ig::::::::::::::rr=: ggrggr.11...1 :: :.ss.: : 31 I I Wood frame 41 I I Private (septic tank, etc.)
• arc rusa.•ura.. • u • •• all floors, based on exterior
=:14.....3 a.:•::::�:ggs g •' ... a ,,, : Imee.:a: : 32 Structural steel
ias:::.::::..s.. . :::a:::::ar:: grimes: : : g : I dimensions
_. s•sa. a. . •�r= = s 'j : sass: :: 33 I I Reinforced concrete H. TYPE OF WATER SUPPLY
!• arsis:••••:•:: a:aaaaa 50. Total land area, sq. ft.
'iii:s::agsa.. ..::: i.•ra.ra.aa•ur =••a: _ Is :: __: _ 34 I I Other — Specify 42 I I Public or private company
,.ia •.r•r rr rr ■• • rr aHa --
'yR:1a:u•=•vi::: :•:::•::aa...••••=•:: �I•"•r: ka::::::::::::::: 43 I 1 Private (well, cistern) K. NUMBER OF OFF-STREET
"• .iaaS::a Sa a.a::iaa:aa::::::::a:: : : :risen. ...
PARKING SPACES
• a asysas::::•aaa::: •sass.• a . ::•::::: •s:
• s:iis• a::::: a:aI� : .. ,..a..i ......asrg sass.:: • .. 51. Enclosed
'� a.•...ar.sri•�Saas..:■:i::a.....::! ••• : :sass::: : F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
: • a . .. • rs:sass... a..aa. a • .s iaa ir.s..•i•. ::sass: : sa.
::a'u: I�asa�ra:asa:.shag:.s .Ue...:•s•ss•• ... ,a,a aaa.a.a.aa..:::::a$ua • s•i a. la:�:rssi::: : a �N: 35 I I Gas Will there be central air 52. Outdoors
: :a:a:a:::::.• .. . • • : s ::.• : s::a car: :
•...aaaa"sans .a sass: u • o. : • • 36 Oil conditioning.
a•::a: ::a:: : ••• :•s: • • a ! a :• : z as a a aa.aaai as:: :Cl::ia=•= IL. RESIDENTIAL BUILDINGS ONLY
as lagig:as a:a:asgua:: •=••=sass.....::aagg:......as•••• .::::i..:.. ...:...:aee.i.:u:u:::s:s::uuii'iii'ii:=• .uuaaa n::::::::::.u... sue 37 I I Electricity 44 Li Yes 45 No 53. Number of bedrooms
• r.ra. N nan uses _ aa•:a::a.. 0 a.a.a..a.. . a.... .:a::a:::::•::: a
-'as asaaa::rug a...sas s :a. i +a•. : a.a. :. .. r ,� „ :u::u...a•.a.r. •. r::•s:sa me I I Coal
1.* aassaa::III a Am MU ga a 41 sla�� IMMEEN •�W ils •raj -- 11111 ��� 1 agg .s:�ra:gga1:1111us�#ar s I I Will there be an elevator.
} • i ii
• rs.u.saass.. a • • 39 Other — Specify
Full
54. Number of
46 I I Yes 47 I 1 No bathrooms
Partial
BOCA FORM APEBP — 669 C1969 BUILDING OFFICIALS & CODE ADMINISTRATORS INTERNATIONAL, INC.
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address - Number, street, city, and State ZIP code Tel. No.
I. 1)/V/p 5 AacV, iV 6�/ %E/fifhCfZhji,/E iAW7 19/Vrom/ /)�/9 0Ap60 ski-�z76 NOTES and Data — (For department use)
Owner or
Lessee SA Noe/9 tCoopiN
/ Builder's �� `�-_ft- / Z2.
GfteHGDR• /9RO/417'6AUGT /7/ GV 'sr- sf Gd HH7--14tLD /nil. �jdS'S License No. ��/a��ll -t*+'« i� ¢
Contractor / Sea 78-1- -.0 0 I--- , .,,Z-jr ✓ ;�3. p7
7,..-7 ,
Architect or LC/� C/
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 /e.-- t" Q
make this ap ation as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature of scant Address Application date
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans Date Plans ByNotes
q Fee Started By Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date 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
Building �� FOR DEPARTMENT USE ONLY
Permit number a
Building. ^ Use Group
Permit issued Ck- t V , 19
Building Fire Grading
Permit Fee $ /6- CX7 Live Loading
Certificate of Occupancy $ Occupancy Load _
Ap ved by:
Drain Tile $
Plan Review Fee $
TITLE