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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and .State- ZIP code T I. No.
Te
Owner or
Lessee
Builder's
2. i 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 a is authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Sign ure of applicant Address Application date
I � ) f 6d NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans B Notes
Fee Started Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL Is
OTHER is
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Date Number B Permit or Approval Ch Date Number
Obtained y pp Check By
y
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 FOR DEPARTMENT USE ONLY
Permit number 7
Building. 7 Use Group
Permit issued "Staf � _ 19
Building Fire Grading
Permit Fee $__ L]/y Live Loading
Certificate of Occupancy $ Occupancy Load
$ Approved by:
Drain Tile �
Plan Review Fee $
TITLE
CITY OF NORTHAMPTON
�. MASSACHUSETTS
d OFFICE of the INSPECTOR of BUILDINGS
Page t� C Plot � �� APPLICATION FOR
ZONING PERMIT AND
INSPECTOR BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. 0
ZONING
AT (LOCATION)
� `(� /r DISTRICT
(• TREET)
LOCATION (NO.)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
V►
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 J�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 fami ly - 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 F-1 Wrecking (If multifamily residential, of units ------- - --). 22❑ Service station, repair garage
enter number of units in building in 15 ® Garage 23 ❑ Hospital, institutional
Part D, 13) 24 E] Office, bank, professional
6❑ Moving (relocation) 16 ❑ Carport
17❑ Other - Speci/y 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,•,••........... 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 $ L16
111. 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 ❑ 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 ❑ 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 f Electricity 44 ❑ Yes 45 !'7 No 53. Number of bedrooms..............
3B Coal
39 ❑ Other - Specify Will there be an elevator? Full..........
-" 54. Number of
46 [-] Yes 47 ❑ No bathrooms
- Partial........
DEPT. OF BUILDING INSPECTIONS gU I LDI NG Z°
212 Main Street <
a.Northampton, MA 01060 PERMIT 40
12C - 78 VALIDATIONy
DATE September 6, 19 85 PERMIT NO. a0IM, 524
APPLICANT James Duffy ADDRESS 56 Carolyn Street Owner
(NO.) (STREET) (CONTR'S LICENSE)
New Building UMBER OF
PERMIT TO g (_) STORY Garage DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
56 Carolyn Street ZONING URA
AT (LOCATION) y DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION /• LOT BLOCK SIZE
BUILDING IS TO BE 24 FT. WIDE BY 30 FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS, permit for the construction of a 2 car gar_ngP
AREA OR VOLUME 720 sq. ft. ESTIMATED COST $ 6,000.00 FEE MIT 24.00
(CUISIC/SQUARE FEET)
OWNER Same as A licant
ADDRESS
Same as pp lcant s BYILDI
WHITE - FILE COPY . GREEN - FIELD COPY ■ CANARY - APPLICANT COPY • PINK - AS ESSORS COPY pjNT P