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I III 1111111111 milli NOTES and Data — (For department use) IV. IDENTIFICATION — To be completed by all applicants Name Mailing address — Number, stmt, city, and Stair ZIP code Tel. No. ,. e4 �,� �d� /4��'✓lc� �1/1� QIQLoO �lv^ t9 Owner or �`""' Lessee G /n 1 /� ,/� 2. �J ��/^( �01. l7lJ� �� �t`� 1`l le- Licenser 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. Signot xy of applicant Address Application date DO NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Required Check Plan Review Date Plans By Date Plans B y Notes q Fee Started Approved BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL $ OTHER $ VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Date Permit or Approval Check Obta ned 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 DEPARTMENT USE ONLY Permit number rC Building Use Group Permit issued �� 19 ��"'� Building Fire Grading Permit Fee $ Live Loading Certificate of Occupancy $ occupancy Load Approved y: Drain Tile $ Plan Review Fee $ f TITLE CITY OF NORTHAMPTON �• MASSACHUSETTS $ OFFICE of the INSPECTOR of BUILDINGS Page b Plot l4 3 APPLICATION FOR INSPECTOR ZONING PERMIT AND BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: 1,, V, )'f 11, 111, IV, and O �IX. ZONING VAj- • AT (LOCATION) ' `- O k- loR rf ry z% e r ! ! + DISTRICT LOCATION (NO.) (STREET) OF BETWEEN AND BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE t/t 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(If residential, enter number 12 One family 18 ❑ Amusement, recreational of new bousing units added, if any, in Part D, 13) 13 Two or more family — Enter 19 L❑ Church, other religious 3 Alteration (.See 2 above) number of units— — — — -� 20�❑ Industrial ❑ _ 14 ❑ Transient hotel, motel,, 21 1 Parking garage 4 ❑ Repair, replacement or dormitory — Enter number 5 El Wrecking (If multi family residential, of units -------- — 22 ❑ Service station, repair garage enter number of units in building In 15 Garage 23 L Hospital, institutional Part D, 13) 16 ❑ 6 [❑ Moving (relocation) Carport 24�� Office, bank, professional 7 ❑ Foundation only 17 C� Other — Specify 25❑ Public utility 26 ❑ School, library, other educational B. OWNERSHIP 27 L❑ Stores, mercantile 8 T— Private (individual, corporation, 28 ❑ Tanks, towers T— 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 processing plant, machine shop, laundry building at hospital, elementary 10. Cost of improvement,,,,,,•,•,•,..,. u � school, secondary school, college, parochial school, parking garage for. deportment store, rental office building, office building at industrial plant. 7'o be installed but not included If use of existing building is being changed, enter proposed use. in the above cost a. Electrical....................... 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 30 ❑ Masonry (wall bearing) 40 D Public or private company 48. Number of stories.............. 31 ❑ Wood frame 410 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 ❑ 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 I. TYPE OF MECHANICAL 35 ❑ Gas Will there be central air 52. Outdoors........................ 36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37 Electricit 44 I Y 45 No y es 53. Number of bedrooms.............. 38 Coal 39 '❑ Other — Specify Will there be an elevator" Full.......... 54. Number of 46 1 Yes 47 No bathrooms Partial....... DEPT. OF BUILDING INSPECTIONS z o 212 Main Street BUILDING 04 Northampton, MA 01060 PERMIT Q 36 - 143 VALIDATION July 25, APPLICANT Howard & Loretta ��berson ADDRESS M roo sideR�°ir. , s (NO.) (STREET) (CONTR'S LICENSE) Above Ground Pool One Family NUMBER of PERMIT TO (_) STORY DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) 308 Brookside Cir. , Florence ZONING URA 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. permitfor the installation of an above ground pool AREA OR 4,000.00_— PERMIT/$, 10.00 VOLUME ESTIMATED COST EE (CUBIC/SO DARE FEET) OWNER Same as Applicants BUILDING K�i�j % W ADDRESS Same as Apo 1 i cant 1 s BY WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY ■ PINK -,"ASSESSORS COPY pjNT P