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17A-292 (4)
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I .• ■ • N aLN•lIrrNlNMI Ll ioll H pup NOTES and Data — (For department use) Z` -- r r� G-C OA Y-S'Z 1-2 -Z " ) � - "-z , IV. IDENTIFICATION - To be completed by all applicants Name Mailing address — Number, stmt, city, and State ZIP code Tel. No. 1. Owner or Okp Lessee Builder's L. License No. Contractor 99 2493 3. Architect or } - D / /� Engineer hG�l[O�dG T 4 �3.� Il�.eaG k. O 1l 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 D0 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 Obtained Number By Permit or Approval Check ObtaDate ined 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 Building- �, �[ Use Group Permit issued -,/�—�'-` 19�_ Building Fire Grading Permit Fee $ 'Z •O Live Loading Certificate of Occupancy $ Occupancy Load Ap r ved by: ^ Drain Tile $ Plan Review Fee $ TITLE CITY OF NORTHAMPTON MASSACHUSETTS r ♦ + e OFFICE of the INSPECTOR of BUILDINGS ,UT Page 17'�j` Plot 2?2 APPLICATION FOR ZONING PERMIT AND INSPECTOR BUILDING PERMIT IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O • AT (LOCATION) O #�V � DISTRICT LOCATION (NO.) (STREET) OF BETWEEN cS „LAG AND BUILDING t11V (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE V1 II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D —f 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 LX 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 n Alteration (See 2 above) 14 � Transient hotel, motel, 21 Parking garage 4 r�� Repair, replacement or dormitory — Enter number 5 u Wrecking (If multifamily residential, of units ——————— — -� 22 L Service station, repair garage enter number of units in building in 15 Garage 23 L] Hospital, institutional Part D, 13) 24 Office, bank, professional 16 � Carport ❑ p 6 Moving (relocation) 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,,,,,,,,,,,,,,,, iv voo 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 $ ,0 D ®,pp 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❑ 48. Number of stories.........""" 2- Masonry (wall bearing) 40 © Public or private company ,� 31 Wood frame 41 Private (septic tank, etc.) 49• Total square feet of floor area, (�S—� x3d all floors, based on exterior q/ 32 Structural steel dimensions ..................... _7 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 F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ....................... Z 35 ❑ Gas Will there be central air 52. Outdoors........................ y, 36 Oil conditioning? ` _&A;t /7 _ L. RESIDENTIAL BUILDINGS ONLY 37 Electricity 44 Y Yes 45 [ No 53. Number of bedrooms.............. 38n Coal 39 C 1 Other — Specify Will there be an elevotoO 54. Number of Ful'......... 46 [-1 Yes 47 E] No bathrooms Partial....... Department of Building Inspections 212 Main Street Northampton, Mass. 01060 BUILDING 00 � �f f z PERMIT 17A - 292 VALIDATION pATE April 10, 19 84 PERMIT NO. 126 APPLICANT Plantation Valley omes ADDRESS O7Fl96tence (N0.) (STREET) (CONTR'S LICENSE) • PERMIT TO New Building (_) STORY One Family Home NUMBER OF DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) Lot # 80 Hillcrest Drive ZONING AT (LOCATION) DISTRICT URA (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE 65 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 constrution of a new single family home with four bedrooms, 22 baths kitchen, living room, family room, and dining room with a garage. Home to be two floor: AREA OR 2 591 s Q' ft. 80 000.00 PERMIT 812.00 VOLUME ESTIMATED COST $ FEE (CUBIC/SQUARE FEET) OWNER _ Anthony Gleason & Mary Ann Gleason 2108 River Run A ts. f Northampton, Mass. BUILD( ADDRESS 01060 BY WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY