43-064 (2) DEPT. FILE COPY
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CITY OF NORTHAMPTON BUILDING .c
NORTHAMPTON, MASS. 01060 PERMIT VALIDATION
43-64
DATE Nomember 1y )9 77 PERMIT NO. 529
APPLICANT _PRO -5_ )arose_ ADDRESS 48 Dunp Dive
(NO.) ( EET ICCNTR'S LICENSE)
NUMBER OF
PERMIT TO Install Chimney (--) STORY Wood bs� S vo DWELLING UNITS 1
(TYPE OF IMPROVEMENT N0. PR D
AT (LOCATION) 48 Du ZSTRG
nPha Drive DISTRICT SR
(NO.) (STREET)
aBETWEEN _ AND
'0 (CROSS STREET) (CROSS STREET(
a _
LL LOT
m SUBDIVISION LOT BLOCK SIZE
a
LI
O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
Go
O
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
M (TYPE)
C
0 IL REMARKS: Block Chimney
AREA OR PERMIT
VOLUME ESTIMATED COST $ 111 FEE . 0.00
(CUBIC/SQUARE FEET)
,,.
OWNER Pa tl S_ Marusek / '
ADDRESS 43 Duaiphy _Drizre, Northampton BYI I`�I.die� ^
(Affidavit on reverse side of application to be completed by authorized agent of owner)
I hereby certify that 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 OF AGENT
ADDRESS
(NUMBER) ;STREET) (CITY)
APPROVED BY TITLE
DATE 19 .
tk,. :/ t City of t"ortl antpton
e; '1 1-4. {sssaci msetts
',...t........-,>/:1.....7r.____....,-
��;y�
(Office of tltr 3Insptrtor of ` uilbings APPLICATION FOR
a ZONING PERMIT AND
Page
3 Plot 1 BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, Ill, IV, and IX. Z
O
I. AT (LOCATION) 47 •VL1„hAV% V' \V'Q_ ZONING c D IS GTS
LOCATION (N0.) (S`TREETT\
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
U)
II. TYPE AND COST OF BUILDING - All applicants complete Parts A - D 33
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m
1 New building Residential Nonresidential
2 Addition(!f residential, enter number 12 N One family 18 n A• musement, recreational
Par housing units added, if any,
in 13 n'i Two or more family - Enter 19 n Church, other religious
Past D, 13) number of units- - - --
3 n A• lteration (See 2 above) 20 n Industrial
14 7 T• ransient hotel, motel, 21 n Parking garage
4 n R• epair, replacement or dormitory - Enter number
5 n W• recking (If multifamily residential, of units - -)► 22 n S• ervice station, repair garage
enter number of units in building in 15 n Garage 23 n Hospital, institutional
Part D, 13) 16 n C• arp ort 24 n O• ffice, bank, professional
6 n Moving (relocation) 7
7 n F• oundation only 17 I I O• ther - Specify 25 n Public utility
Ai-
,/ + 26 n School, library, other educational
B. OWNERSHIP ALoGK- C.1'�11'-1,-,t / 27 n Stores, mercantile
8 IPrivate (individual, corporation, ! 28 n T• anks, towers
4
nonprofit institution, etc.) 29 n Other - Specify
9 n 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 S 7j DS- 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
I
d. Other(elevator, etc.)
11. TOTAL COST OF IMPROVEMENT $ "3;).S t! 0
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L; ,D
for wrecking, complete only Part J, for all others skip to IV. y
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS m
m
4830[Masonry (wall bearing) 40 n Public or private company Number of stories
31 n W• ood frame 41 n P• rivate (septic tank, etc.) 49. Total square feet of floor area,
all floors, based on exterior
32 n S• tructural steel dimensions
33 n R• einforced concrete H. TYPE OF WATER SUPPLY
34 n Other - Specify 42 n P• ublic or private company 50. Total land area, sq. ft.
43 n Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL 51. Enclosed _ O
35 n G• as Will there be central air 52. Outdoors -+
36 n Oil conditioning? _ L. RESIDENTIAL BUILDINGS ONLY
37 n E• lectricity 44 n Yes 45 I No 53. Number of bedrooms
38 n Coal
39 n Other- Specify Will there be an elevator? Full
54. Number of
46 n Yes 47 n No bathrooms
Partial
IV. IDENTIFICATION — To be completed by all applicants
•-- ya
Name Moiling address — N,mbc'r. strut, r!r>, and Slate ZIP code Tel. No.
—
I.
?I:4.U. 14R 0u 4, ��\ � r �,G
Owner or
Lessee WVa.hu%� t/ w .0 0
1 �L i r
O ,/ BOfder's
2. f3 t L� 1'�/�A-10'v1 1 _ l4.
,2t � s 1 hQ VV L License Ivo. -
Controctor
S U vA` ```_
r w l KV -D ss
I
Arch.rect cr - -
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 jurisdiction.
ifs$ titre of applicant Address Application date
c,...~,,..4....5 , or.,..•. ,,V,. l
DO NOT WRITE BELOW THIS LINE
1
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans Notes
G Fee Started y Approved By
BUILDING
PLUMBING iS
MECHANICAL $ y
ELECTRICAL $
OTHER S
r 1 , A 1 . . 4
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
DPermit or Approval Check Obttained Number By Permit or Approval Check Obttained 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 a 7
Permit number of
Building
Permit issued - / 1977
Building
Permit Fee S /D_ Q6/
Certificate of Occupancy S
Appr• • by:
Drain Tile S41111117/ ,eiv /
Plan Review Fee S_
i
TI LE
1
NOTES and Data — (For department use)
VIII. ZONING PLAN EXAMINERS NOTES
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT PLAN — For Applicant Use
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