43-070 (4) DEPARTMENT OF BUILDING INSPECTIONS iDEM. FILE COPY
zD
212NS';`E %. 01060 BUILDING =a
PERMIT a,,,aN
43 » 70 Code #79
DATE April 14. to $D PERMIT NO. 176
APPLICANT Richard B. Moulin ADDRESS P.O. Bax 12, Goahaa, Ma.
(SO.) (STREET) (CONTR4 LICENSE)
OF
PERMIT TO Alteration (, 2 ( STORY Finish tad_ floor DWELLpING UNITS 1
(TYPE OF IMPROVEMENT} XO. (PROPOSED Uses
ZING
AT (LOCATION) 96 Daanby Drita .DISTRICT $R
(NO.) (STREET)
BETWEEN_ AND
(CROSS STREET) (CROSS STREET)
LOT
Q SUBDIVISION LOT BLOCK SIZE
O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
Z TO TYPE USE GROUP... .. ....BASEMENT WALLS OR FOUNDATION
Y (TYPE)
0
A• REMARKS: Finish I bedrooms & batty add I dormers s 2 Front & 1 rear* 1 smoke existing,
Insulate rogf, �j 64t y3;/et E. 4,717.'
VAREA OROLUME__.. C-/A.� • '"^M" ESTIMATEDMA"` COST $ 6400 WI PERMIT
VOLUME
$ 214,00
(CUBIC/SQUARE FFET) W
OWNER David Bickford / /
ADDRESS 46 annphq Drive, a tan, .rlLDln. .� j_IS `v
(Affidavit on reverse side of application to be completed by authorized agent of owner)
I hereby certifythat the proposed work is authorized by the owner of record
and I have been authorized by the owner to make this application as his -
authorized agent.
SIGNATURE SOF AGENT r
ADDRESS -_
(NUMBER) (STREET). .. (CITY)
APP-ROVED BY TITLE
DATE 19_.
A 1
CITY OF NORTHAMPTON
OFFICE OF THE INSPECTOR OF BUILDINGS
212 MAIN STREET APPLICATION FOR
NORTHAMPTON, MA. 01060 PLAN EXAMINATION AND
tel — 7D BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: I, II, III, IV, and IX. o
FOXING `t.�
I- AT ttocanoxi 7nn a I1U,hJDhEY I1tir/vF crstalcT-S I
LOCATION ,npa tsTseeer
OF PETWEENAND
BUILDING 'CROSS STFLEr} (CROSS RTREET)
LOT
__ LOT BLOCK Sur
II. TYPE AND COST OF BUILDING — Al? applicants complete Parts A — O z
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
I (II New building Residential Nan sidential W
2[ i Addition Of residential, eater number 12(ky we tmmity 18)re 1 Arnsentent, recreational
of new housing rrsrit_S added. if any,
in Part 0, 13) 13(i T• wo or more lardy — Enter 191 I Church, other religious
number o/uniIS——— _ ..* 20 ri Industrial
3 VA lteretion (See 2 above) 14 E1 T• ransient hotel, morel,
4 I Repair, replacement or dormitory — Enter number 21 —� Parking garage
5 El Wrecking /if muttife,nily residential. of units y. 22( Servicea tion, repair garage
eater number of units in building in is L,_..1 Owage 23(J Hospitol, institutional
Pmt 0, 13) 16 �, Carport 24 1 Office, bank, professional
6 I Moving (relocation) - 251 Public unlit
7 fi Eaunaa,ron 111.......1 O• ther — sunci/yy
only 25 1 I School, library, other educational
B. OWNERSHIP 27 El Stares, mercantile
[
8 pity a(individual, corporation, 28 LT] Tanks, towers
nonprofit institution, etc.) ,........ 291 I Other _ Specify _.
9 ( Public (Federal, State,or
local government)
C.COST (Omit cents) Nonresidential — Describe'in detail proposed use of buildings,e. .,feed
p p
YFprocessing onamachine shop, build/ng et kpangr
for
10. Cos, of improvement gO 100.0°-school, secondary school, college, parochial
ro i choof6 parking garage fo ,/ deportment store, rental office building, office ending inuseplant.
he installed but not included If use of existing building Is being thengod, enter proposed use.
in the abvecost
a. Electrical
b. Plumbing �� i--
v.Hearing, air conditioning r.." --- '
d.Other(e to aro, e2.) / ,( —
11, TOTAL COST OF IMPROVEMENT b 4 400-co
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
for wrecking, complete only Port .1, for all others skip to IV,
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS ryry
30 C]M my pony
(wail bearing) 401 1 Public or private coin Number of stories K
49. Total a feet of Door area,
31 Wood frame 41 N. Prison (septic tank,etc.) square
all floor.,, based on exterior94
32 I I Structural steel dimensions
33 1 I Reinforced concrete H. TYPE OF WATER SUPPLY
341 I Other - specify 42 tg Public ar private company e-0- Tatd and area, sq.ft
43( Private(welt, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
k 51. Enclosed
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL — --
35;hI Gas Will there be central air 52. Outdoors
L
35 y Oil conditioning?
EX
L. RESIDENTIAL BUILDINGS ONLY
37 iI Electricity 441 Yes 35"L-� No 53. Number of bedrooms 3
38I I Cool
•�`"�, / -
39 I Other — Specify Will there be on elevator? { Fyn_;,K 54. Number at jt}
451 Yaa 47I AI No bathrooms
Partial
r 14
NOTES and Data — (For department use)
IV. IDENTIFICATION - To be completed by all applicants
Name Moiling address — Number, street, city, and trate ZIP code Tel. No.
awne, or DA UID I31ris1;04 96 bum AL)/ Dv.) Nnv7hAinProw, fl 3S16-3CCA,
Lessee
.. #441014113vtlrErs Co• /e oy /a Conh6N i hR• Licenser No.
Contractor
Rte AAwd l3' Mnrclu t.1A-ray Nodyd Plate —Lab-3772
Architect or
Engineer
I hereby certify that the proposed work is authorized by the owner of record and that I hove been authorized by the owner to
make this application as his authorized agent and we agree to conform to all applicable laws of this io isdicrion.
Signature ofapplicant Address Application date
c�a
� A / `a Po• aav e2 foshpp 7 IaA • 4/1¢1tfo
'GO NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD - For office use
Plans Review Required Check Plan Review Date Pions Date Pions Notes
quire Fee Started By Approved By
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Permit or Approval Check Obtained Number By Permit or Approval Check Obta rued 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 6
Building / pi 19 Ire Use Group
Permit issued ((
Building -� �Z -- Fire Grading
Lam-"-
Permit Fee $ `�� Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by:
Drain Tile $
Plan Review Fee $ d
VIII. ZONING PLAN EXAMINERSjNOTES
DISTRICT /?
USE /�//
FRONT YARD,/
SIDE YARD SIDE YARD
REAR YARD
NOTES ^_ Cf�a_
IX. SITE OR PLOT PLAN - For Applicant Use 3 -}
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BOCA FORM APEBP - 6E9 CI969 BUILDING OFFICIALS 8 CODE ADMINISTRATORS INTERNATIONAL, IN:.