18D-026 (17) ., I�PARTM6'NT OF BLDG. INSPOOTIONS A DEPT FRF 00Y
2i2' NDRRNAMPi'ON 01060 BUILDING SA enJEn.tig 3MP[. '
188 { 26 CODE M79 -PERMIT VALIDATIONf
DATE Seot:= 26.' is 79 PERMIT N0. err E
APPLICANT i$dyard 1 Ann ADDRESS 55 Damon Bd
Addition
(NO.) IFTR EE TI IC ONTR•S LIFER'S')
Adda
PERMIT TO tion (1) STORY truck & oar port NUMBER OF UNITS
STYPE Or IMPROVEMENT) MO. (PROPOSER VSE}
AT (LOCATION) 55 Damon R&B "Bak Tire",,,,, DISTRICTZONGI
110.1 )STREET(
• BETWEEN_ AND
•
(CROSS STREET) [CROdd STREET)
A. T
SUBDIVISION LOT BLOCK SLDE ._
y �dd „
Addition
p sEy22221' TO BE 11 FT. WIDE BY 32 FT. LONG BY 18 FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
•
a
S TO TYPE _. USE GROUP _ BASEMENT WALLS OR FOUNDATION
S RTPEI
C
•• REMARKS) Addition of existing garage (3 sided yo ) 4_
BO5K I'.. C••.. - +C.^ 4F R -` A.enC Il•• 13-05 /?M8AREA
$
VOLUME ESTIMATED COST 1.000 j FEEMIT y. iO$ O
ICVBIU'pUAflE FEET) BY Ea
'VP '_'`P.r``E `-j'rP`E
OWNER Edward &: Morennnn _ BOIL
Ili
ADDRESS_... 5 Damon Rd . y Btozffi
(Affidavit on reverse side of application to be completed by authorized agent of owner)
I hereby certify that the proposed work is authorized bythe ownerof recall
and I have been authorized by the owner to make this application as his
authorized agent.
SIGNATURE OF AGENT •
_ . .
_
ADDRESS
(NUMBER) . (STREET) (CITY}
•
APPROVED BY TITLE
DATE 19_.
i
•
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 8U — ; G PLAN EXAMINATION AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, II, III, IV, and IX. O
((/ �. / 11 //A & . t r ZONING T
AT (LOCATION) ‘cc1 0 .�?Yt/ /(A'/VA/ a . :/t 4 OisTFICTs-
LOCATION INO.) ISTREETI
OF BETWEEN AND
BUILDING (CROSS STREET) (rimer STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
(A
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D -I
A
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
m
-I
1 I I New building Residential Nonresidential
2 X Addition(If, smential. enter number 12I I One family 181 I Amusement, recreational
mf nem housing units added, if any, 131 I Two or more family - Enter 19 P 1 Church, other religious
�/ in Part D, 13) amber of units----y 201 1 Industrial
3 �I Alrerati on (See 2 above) 141 I Transient hotel, motel, 21 El Parking garage
41 I Repair, replacement or dormitory - Enter number
5 I I
multiin number of units building in 15n Garage 23 I I Hospital, institutional
Part D. 13)
16 241 Office, bank, professional
6 L 1 Moving (relocation)
T Foundation only
171_1
1_1I Other
r -Specify 25 El Public utility
261 J School, library, other educational
B. OWNERSHIP 27I L Stores, mercantile
8 Private (individual, corporation, 28 1 I Tanks, towers 1_,,
nonprofit institution, etc.) 29 rg..[Other - SpecifyCLN ViI' T'
9 1 1 Public (Federal, State, or vt
local
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
ondary school, college, parochial school, parking garage for
departmentstore, 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 r-y y X 2 ;5(-1'
•
b. Plumbing
/ i�`
c.Heating, air conditioning ,�//�..�
d. Other (elevator, etc.) r d "-"'� 2t'_ . .U-....§--1./
11. TOTAL COST OF IMPROVEMENT b /1 CCV —
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
48. Number of stories /
30 C141-Mosonry (w011 bearing) 40 I Public or private company
49. Total square feet of floor area,
31 Wood frame 41 Private (septic tank, emJ all floors, based on exterior
32 1 1 Structural steel dimensions
331 I Reinforced concrete H. TYPE OF WATER SUPPLY
341 I Other - Specify 42 n Public or private company 50. Total land area, sq. ft
43 I Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL SL Enclosed
35 1 1 Gos Will there be central air 52. Outdoors
36 7 Oil conditioning?
L. RESIDENTIAL BUILDINGS ONLY
37 n Electricity 44 I Yes 451L No 53. Number of bedrooms
381 I Coal
39 7 Other- Specify Will there be on elevator? 1 Full
54. Number of (1l
46 I Yes 47 1 No bathrooms
Partial
NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name _ Mai ling address — Number, .street, city, and State ZIP code Tel. No.
Owner or , /6 O, ��C_ sSRc! —
Lessee te•A ..,i beZif `77667)
-
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 this application as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
SiSixThiature of applicant>i, Address ApplicationClidote
/' f 4 0,9'6
un ser; `r'r"� - �9
DO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Dote Plans By Date Plans By Notes
Fee Started Approved
BUILDING -$ -.-■
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Dote
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
VII. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building �+ Use Group
Permit issued _ "� 79 1 I
Building ////��// Fire Grading
Permit Fee $ I`�' L Live Loading
Certificate of Occupancy S Occupancy Load
prove by:
Drain Tile
Lin
Plan Review Fee $
TITLE
VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT _.
USE 4
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN.,*,
— For Applicant Use
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S INFEPNatIDNAL, INC.
SOCA FOAM APEBP - 669 CI969 BUILDING OFFICIALS 6 CODE ADMINISTRATOR