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IDENTIFICATION — To be completed by all applicants Name Mailing address — Number, street, city, and State ZIP code Tel. No. Owner or �ro`A/1.C//�G� Lam!S G �0/t 0C 7 Lessee Builder's 2. ��' tia.� License No. Contractor 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. S ig no of, pplica P Address Application date �) ��-�-�� �,��-,mss 00 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 Is OTHER Is VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approval Check Date Number By Permit or Approval Chec Date Number B Obtained obtained 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 II. VALIDATION Building Y r 2] FOR DEPARTMENT USE ONLY Permit number —t Building. ' f' Use Group Permit issued ��� -9 Iq Bui Iding Fire Grading Permit Fee $ CC�•C`, ) Live Loading Certificate of Occupancy $ Occupancy Load Approve Drain Tile $ Plan Review Fee $ TITLE CITY OF NORTHAMPTON �• e s 0` MASSACHUSETTS $ s OFFICE of the INSPECTOR of BUILDINGS t Page Plot 7� APPLICATION FOR INSPECTOR ZONING PERMIT AND BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. O ZONING I• AT (LOCATION) _ _ D STR C LOCATION (NO.) (STREET) OF BETWEEN AND BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE N II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m m 1 ❑ New building Residential Nonresidential 2 Addition(l/ residential, enter number � 12�One family 18 ❑ Amusement, recreational of new housing units added, if any, in Part D, 13) 13❑ Two or more family - Enter 19 ❑ Church, other religious number of units- - - - •-> 20 ❑ Industrial 3 ❑ Alteration (See 2 above) 14 ❑ Transient hotel, motel, 21 ❑ Parking garage 4 ❑ Repair, replacement or dormitory - Enter number 5 ❑ Wrecking (11 multifamily residential, of units ------- - -� 22 ❑� Service station, repair garage enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional Part D, 13) ❑ 16 Carport 24 ❑ Office, bank, professional 6 ❑ Moving (relocation) 17�--Other Specify �u�<y�Lp.�i`�� 25❑ Public utility 7 ❑ Foundation only 26 ❑ School, library, other educational B. OWNERSHIP ���L 27 Stores, mercantile 6 [5�_Privote (individual, corporation, 28 ❑ Tanks, towers nonprofit institution, etc.) 29 ❑ Other - Specify 9 ❑ Public (Federal, State, or local government) C. COST (Omit cents) Nonresidential - Describe in detail proposed use of buildings, e.g., food q_ processing plant, machine shop, laundry building at hospital, elementary 10. Cost of improvement••,,•,•,,..,.•,. JC 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 a. Electrical..................... �R b. Plumbing ..................... c. Heating, air conditioning......... d. Other (elevator, etc.)............. 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 30fi4Masonry (wall bearing) 40 ❑ 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 32 ❑ Structural steel dimensions ..................... 33 ❑ Reinforced concrete H. TYPE. OF WATER SUPPLY 34 ❑ Other - Specify 42 F-] Public or private company 50. Total land area, sq. ft. .......... 43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed ....................... F. PRINCIPAL TYPE OF HEATING FUEL 1. TYPE OF MECHANICAL 35 ❑ Gas Will there be central air 52. Outdoors........................ 36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37 Ll Electricity 44 ❑ Yes 45 ❑ No 53. Number of bedrooms.............. 38 Coal 39 ❑ Other - Specify Will there be an elevator? Full.......... 54. Number of 46 ❑ Yes 47 No bathrooms Partial....... i e DEPT. 01F9ADING INSPECTIONS BUILDING Z° 212 Main Street $a Northampton, MA 01060 PERMIT <a 29 — 15 VALIDATION DATE.July 22, 9 85 ERMIT NO, 431 APPLic�0and Dupuis ADDRESS �Z4 1�1TcTory Drive Owner (NO.) (STREET) (CONTR•S LICENSE) PERMIT TO Addition (_) STORY In-Ground Pool NUMBER NG UNITS (TYPE Of IMPROVEMENT) NO. (PROPOSED USE) AT (LOCATION) 24 Hickory Drive ZONING URA CT (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE PWLL r� I IS TO BE 18 FT. WIDE BY 36 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: permit for the installation of an inground swimming pool AREA OR VOLUME 648 sq. ft. ESTIMATED COST $ 21500.00 FEEMIT 10.00 (CUBIC/SQUARE FEET) OWNER Same as Applicant Same aS pp scan s BUILDING ADDRESS BY wvz WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSE SORS COPY PlINf P