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NOTES and Data — (For department use) IV. IDENTIFICATION — To be completed by all applicants Name Mailing address - 10irnber, street, city, and .State ZIP code Tel. No. O wner or tl� 77tu� O Lessee �Uf Builder's 2. 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 th s app cation as his auth ri ed agent and we agree to conform to all applicable laws of this jurisdiction. Signature of is t /r Address Applica 'on d e 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 Date Date Permit or Approval Check Obtained 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 / FOR DEPARTMENT USE ONLY Permit number l>' Building i - , Use Group Permit issued �'a 1' ``' "r 9 ,r Building Fire Grading Permit Fee / j `C: Live Loading Certificate of Occupancy $ Occupancy Load Approved by: Drain Tile $ 0 Plan Review Fee $ TITLE CITY OF NORTHAMPTON g• MASSACHUSETTS $ OFFICE of the INSPECTOR of BUILDINGS Page C Plots APPLICATION FOR INSPECTOR ZONING PERMIT AND BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. 0 � ZONING I• AT (LOCATION) / DISTRICT LOCATION / (NO.) (STREET) OF �fE �-(LL� L,/�NC AND S 1I) & TQA� BETWEEN 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 QR IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m 1 New building Residential Nonresidential 2 ❑ Addition(If 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- - - - -p- 20 ❑ Industrial 3 ❑ Alteration (See 2 above) 14 ❑ Transient hotel, motel, 21 ❑ Parking garage 4 ❑ Repair, replacement or ormitory — Enter number 5 ❑ Wrecking (If multifamily residential, o/ 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 ❑ Moving (relocation) 17 E:] Other - Speci/y 25 ❑ Public utility 7 ❑ Foundation only 26 ❑ School, library, other educational B. OWN HIP 27 ❑ Stores, mercontile 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 r processing plant, machine shop, laundry building at hospital, elementary 10. Cost of improvement................ /Q 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 1 E�C> � 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❑ sonry (wall bearing) 40 ❑ Public or private company 48• Number of stories........... 31 ✓Wood frame 41 ❑ Private (septic tank, etc.) Total square feet n floor area, S all floors, based on exterior 32 ❑ Structural steel dimensions ..................... r 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 F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed ....................... 35 ❑ Gas Will there be central air 52. Outdoors........................ 36 ❑ Oil conditioning? �- / L. RESIDENTIAL BUILDINGS ONLY 37 E] Electricity 44 n Yes 45 ` _ No 53. Number of bedrooms.............. 38 ❑ Coal 39 ❑ Other - Specify Will there be an elevators 54. Number of Full.......... 46 n Yes 47 �o bathrooms Partial........ i a DEPT. OF BUILDING INSPECTIONS BUILDING 2000 ! 212 Main Street O< Northampton, MA 01060 PE RMIT 17C - 309 VALIDATION DATE November 14 g PERMIT NO. 656 Williams APPLICANT Anthony R. W ADDRESS (NO.) (STREET) (CONTR'S LICENSE) PERMIT TO New Building (_I STORY 2 Car Garage/Storage NUMBER NG UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) AT (LOCATION) 9 Hillcrest Drive ZONING Ux 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: permit for the construction of a 2 car garage/storage area ARA VOLUME 576 sq. ft. ESTIMATED COST � 10f000•0O FEEMIT .� 40.00 (CUBIC/SQUARE FEET) OWNER Same as Applicant 0j BUILDIN D ADDRESS Same as AT)zi l lrants BY WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY po.,-fp