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IDENTIFICATION — To be completed by all applicants A' Name Mailing address — Number, street, rite, and State ZIP code T.I. No. 1. r -i } Owner or u t :-/ f t` IC,� C, Lessee Baca tldeir's 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. Signature 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 By Notes Fee Started Approved BUILDING PLUMBING MECHANICAL ELECTRICAL OTHER VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approval Check obttaaineed 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 II. VALIDATION Building Permit number Building -19 � Permit issued .c, � 7 Building Permit Fee $ --;7 �. Certificate of Occupancy Approved by: Drain Tile Plan Review Fee TITL O� o � � flGlsss�tdptsetfs �a t Office of t4v �nsptrtor of Auilbrilgs APPLICATION FOR Page� Z—Plot ZONING PERMIT AND BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. p I• ZONING AT (LOCATION) ,( -(' {.. l C�a DISTRICT LOCATION (NO.) (STREET) OF BETWEEN AND BUILDING (CROSS STREET) (CROSS STREET) SUBDIVISION LOT BLOCK LOT N II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D m A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use (n 1 [ ' Iew building Residential Nonresidential 2 F-1 Addition(If residential, enter number 12 One family 18 Amusement, recreational of new housing units added, if any, in Part D, 13) 13 F_� Two or more family -• Enter 19 Church, other religious 3 [:] Alteration (See 2 above) number of units- -- - - > 20 Industrial �• 14 D Transient hotel, motel, 21 P � arking garage 40 Repair, replacement or dormitory - Enter number 5 ❑ Wrecking (If multifamily residential, of units ------- - --I,- 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 F-1 Moving (relocation) 17 [_1 Other - Specify— 25 Public utility 7 Foundation only 26 School, library, other educational B. OWNERSHIP 27 Stores, mercantile 8 Private (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 processing plant, machine shop, laundry building at hospital, elementary 10. Cost of improvement•,••••,,,....... ;^'y '' 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..................... b. Plumbing ..................... c. Heating, air conditioning.......... d. Other(elevator, etc.)............. 11. TOTAL COST OF IMPROVEMENT $ - `I •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. D, x E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS 17 m 30[�] Masonry (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 F-1 Structural steel dimensions ......... / 33❑ Reinforced concrete H. TYPE OF WATER SUPPLY 17 iyX 42 Public or private company 50. Total land area, sq. ft. ........... 'i_2 34 Other - Specify J✓J P P y 43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed ...................... r F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL O 35 F-1 Gas Will there be central air 52. Outdoors........................ t 36 ®'"Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37 [:] Electricity 44 D Yes 45 [�No 53. Number of bedrooms.............. 3 38 F-1 Coal 39 0 Other - Specify Will there be an elevator? 54. Number of Full.......... 46 [:] Yes 47 [j o bathrooms Partial....... �` I hereby certify that the proposed work is authorized dy the owner-of'record- and I have been authorized by the owner to make this application as his authorized agent. e SIGNAtORE O V AGENT ADDRESS (NUMBER) (STREET) (CITY) APPROVED BY TITLE DATE 19 CITY OF NoRTHANiPTON Z o DEPT. FILE COPY � i BUILDING NoRTa ! wN, mA. o1o6o 3 F7 PERMIT VALIDATION DATE April 24, ig 78 PERMIT NO. 124 APPLICANT Theodore Towne ADDRESS 53 Pat Hill Rd., N'ton. (NO.) (STREET) (CONTR'S LICENSE) NUMBER OF PERMIT TO New Residence ( I ) STORY Residence DWELLING UNITS 1 (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ZONING SR AT (LOCATION) R't 66 WeathaW±T Rnad DISTRICT (NO.) (STREET) a BETWEEN AND m (CROSS STREET) (CROSS STREET) IM LOT a SUBDIVISION LOT BLOCK SIZE m U BUILDING IS TO BE 74 FT. WIDE BY 28 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION to O Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION I (TYPE) Ir IL REMARKS: C'.nnAtrUQ't GnRAfAndlp residence AREA OR VOLUME 135 ESTIMATED COST $ 2 FE EMIT .� 7+.00 (CUBIC/SQUARE FEET) ' ti OWNER m3patinra TflT.11"IA BUIL�4NG D T. ADDRESS 53 Park Hill Rd, , N/ton. BY (Affidavit on reverse side of application to be completed by authorized agent of owner)