38-070 (3) Z o DEPT: FILE COPY,
Z-
CITY OF NORTHAMPTON BUILDING a a
NORTHAMPTON, MASS. PERMIT VALIDATION
38-70 I
DATE Nevembe4 14, 19 !72 PERMIT NO. �
APPLICANT Ge'L� 3# d Ma I nni n ADDR"S 1A3 QrOVB 54-� �tfln�
I (NO.) (STREET) (CONTR'S LICENSE)
NUMBER OF1
PERMIT TO Construet Firerla.ce !Fireple.ce DWELLING UNITS 1
(�) STORY
(TYPE OF IMPROVEMENT NO. 1-- (PROPOSED USE)
ZONING
AT (LOCATION) 163 Grove Street DISTRICT U"
(N0.) (STREET)
t
(
a BETWEEN I AND
a (CROSS STREET) (CROSS STREET)
IL LOT
m SUBDIVISION LOTBLOCK SIZE
a
U BUILDING IS TO BE FT. WIDE BY FT. LONG(BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
O
Z TO TYPE USE GROUP B,SEMENT WALLS OR FOUNDATION
I
Ir (TYPE)
LL REMARKS: Construct Firapip-ne
AREA OR .1
VOLUME ES ]MATED COST $ lOOO OO FEE
MIT
(CUBIC/SQUARE FEET) � $ 14-oo
OWNER Gerard. Malouin t
Grove Street Northampton BUaD
r , orth�ID}itn BY
ADDRESS 16
w
(Affidavit on reverse side of application to be completed by authorized agent of owner)
-
� f.
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' OFt AGENT
ADDRESS
(NUMBER) (STREET). (CITY)
APPROVED BY TITLE
DATE 19
� � �lass�dfusetts
T Office of the "lluspertor of 'Puilbings APPLICATION FOR
ZONING PERMIT AND
Page Plotz_ BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. p
uA _
(• ZONING
AT (LOCATION) 1413 6; DISTRICT (/RJ
LOCATION (NO.) (STREET)
OF BETWEEN a�'FIrl , AND XT
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
y
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
M
A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use M
1 ❑ New building Residential Nonresidential
2Addition(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 fomily - Enter 19 ❑ Church, other religious
number of units- - - - -+- 20 ❑ Industrial
3 ❑ Alteration (See 2 above)
14 ❑ Transient hotel, motel, 21 ❑ Pocking garage
4 ❑ Repair, replacement or dormitory - Enter number
5 F-1Wrecking (If multifamily residential, of units ------- - --> 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 ❑ 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,,,,,,,,,,,,,,,, Clz7-6,%:`O 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 Is &V-e.
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. y
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS M
M30 Masonry (wall bearing) 40 Public or private company 48• Number of stories................
31 ❑ Wood frame 41 ❑ Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior
32 ❑ Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other - Specify 42 ublic 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 ....................... O
35 ❑ Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 6jj4lectricity 44❑ Yes 45 ❑ No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other - Specify Will there be an elevator? 54. Number of Full..........
46 ❑ Yes 47❑ No bathrooms
Partial.......
IV. IDENTIFICATION — To be completed by all applicants
Name�/ /J Mailing address — .A'1onI)CT strc°cl, cath, aml .C(atc ZIP`c1odde Te I. No.
1.
Owner or Ld /y l9 " y r7l ���[J� �� Q/V b6) �J O�f Yjfe,
Lessee
�ais> 'r— /dor yr�sSder 5
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.
Signature
o,f, applicant Address Application date
Z,
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 S
PLUMBING
MECHANICAL
ELECTRICAL
OTHER
Vi. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
rova I Check Date Number B Permit or A rova I Check Obtained Date Number B
pp Obtained y pp y
Permit or A
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
Permit number 7
Building L �
Permit issued /L `L✓ ��� _ 1977
Building
Permit Fee $
Certificate of Occupancy S
Ap�-'ed, by:
Drain Tile (45, �.
Plan Review Fee _
TITLE
NOTES and Data — (For department use)
ZONING •
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