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NOTES and Data — ( For department use)
.ws
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
Owner or
1.0, Ali4 r7 IYIoc,e X196 dor -ex.. � 77�u�C•�..�t z c ; bra; . c; 06o 574/ z�g3
Lessee
749/1 %1 Bui Ider's
2. .LGL4,&4(,. 4��.K / �}C�t�" 4 � �' €.44 s � License No.
Contractor U U �/
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 authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Sign�ure f • cant �jJ �' Address lc �t� j Application date
CUj , /he I( /"� �i r 7�I�t �efi'.L� /1 /3 -Z
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date
Permit or Approval Check Obtained Number By Permit or Approval Check
l A
Date
i
P
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 y.
Building Use Group
Permit issued 4 ,_. f ��� <i�l l i 3 / 19 _
Building Fire Grading
Permit Fee $ Live Loading
Certificate of Occupancy $ Occupancy Lood
Approved by:
Drain Tile $ £ sr4 '`.
Plan Review Fee $
TITLE
r 1"4 • • - CITY OF NORTHAMPTON
MASSACHUSETTS
OFFICE of the INSPECTOR of UILDINGS /
+�- Page /3 P Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: I, I1, 111, IV, and IX. 0
ZONING /
I. AT (LOCATION)/ 16-41--.64-- DISTRICT_V / _
LOCATION (NO.) (STREET)
OF BETWEEN /00 AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
H
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D —1
73
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For "Wrecking" most recent use m
m
1 I I New building Residential Nonresidential
2 I I Addition (1/ residential, enter number 12 ri One family 18 I I Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 I I Two or more family - Enter 19 Li Church, other religious
number of units ---)- f
- - - - 20 VII Industrial
3 I Alteration (See 2 above)
14 ri Transient hotel, motel, 21 Parking garage
4 I I Repair, replacement or dormitory - Enter number 22 I I Service station, repair garage
5 I Wrecking (If multifamily residential, of units - .. ). 1
enter number of units in building in 15 I 1 Garage 23 Li Hospital, institutional
Part D, 13)
16 n Carport 24 1 1 Office, bank, professional
6 I I Moving (relocation)
17 Li Other - Specify 25 Li Public utility
7 I I Foundation only
26 1 I School, library, other educational
B. OWNERSHIP 27 r—I Stores, mercantile
8 1 (individual, corporation, 28 I I Tanks, towers
nonprofit institution, etc.) 29 Ei Other - Specify
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 $ 4)50 UG " school, secondary school, college, parochial school, parking garage for,
department store, 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.
in the above cost 1
a. Electrical , ttii N1 N1 ��,-r4
b. Plumbing ' n
c. Heating, air conditioning
d. Other (elevator, etc.) 3 / ��
11. TOTAL COST OF IMPROVEMENT $ ) & .(4)
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 fl Masonry (wall bearing) 40 L; Public or private company 48. Number of stories
31 Wood frame 41 Private (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior /l o
321 Structural steel dimensions
t -'�C '
33 I I Reinforced concrete H. TYPE OF WATER SUPPLY
`0 `61
34 p Other - Specify 42 A Public or private company Total land area, sq. ft.
43 L_ Private (well, cistern) K. NUMBER OF OFF- STREET
PARKING SPACES
51. Enclosed
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL
35 k Gas Wi ll there be central air 52. Outdoors
J
36 L Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 I r� Electricity 44 I Yes 45 rx No
53. Number of bedrooms
38 L i Coal
39 n Other - Specify Will there be an elevator' Full
54. Number of
46 L 1 Yes 47 X No bathrooms
Partial
DEPT. BUILDING INSPECTIONS BUILDING z ° , ,
<,,.._ 212 Main Street $a
:> Northampton, MA 01060 PERMIT
18D - 4 VALIDATION
DATE November 13, 19 87 PERMIT NO. 762
APPLICANT William Mock ADDRESS 106 Damon Road Owner
(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TO Alteration l_ 1 STORY Industrial DWELL UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
100 Damon Road ZONING GI
AT (LOCATION) DISTRICT
(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: permit to put in new stairway and windows on existing building
VOLUME ESTIMATED COST $ 2 �nf _ 0 PER 10.00
(CUBIC /SQUARE FEET)
OWNER Same as Applicant c
BUILDEPT.
ADDRESS Same ac Appl Kant I S BY C 3?_ir
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY pINT p