38-072 (3) Department of Buiing Inspections
212 ruin Street BUILDING Zo lQ
Northampton, Mast, 03060 PERMIT
38A - 72&77 as
VALIDATION
APPLICANT Eric Jensen
DATE May 18, 19 83 PERMIT NO. 237
ADDRESS 141 Grove Street 007264
(NO.) (STREET) (CONTR'S LICENSE)
-- PERMIT TO Alteration (_) STORY NUMBER OF
DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION) 141 Grove Street ZONING
(N0.) (STREET)
DISTRICT- TJRR
BETWEEN AND
(CROSS STREET) (CROSS STREET)
SUBDIVISION LOT
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: Alteration to second floor three (3) bedrooms and on (1) hath-
AREA OR
VOLUME ESTIMATED COST $ 7 nnn-nn FEE
MIT 16
(CUBIC/SQUARE FEET) $ �of)
OWNER __ Eric Jensen
U
BT
ADDRESS -- 141 Grove S1tr et e6.�-_"Y
WHITE - FILE COPY . GREEN - FIELD COPY e CANARY - APPLICANT COPY • PINK - ASSESSORS COPY
CITY OF NORTHAMPTON
.� MASSACHUSETTS
OFFICE of �� INSPECTOR � BUILDINGS
,uT Page Plot APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING
I• AT (LOCATION) / Arrv� DISTRICT
LOCATION (NO.) (STREET)
OF BETWEEN AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
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 L❑ Church, other religious
number of units— — — — � 20 Industrial
3 � Alteration (See 2 above) 14 ❑ Transient hotel, motel, ��
4 Repair, replacement 21 ❑ Parking garage
r� or dormitory — Enter number
5 L 1 Wrecking (Il multifamily residential, of units ------- — 22 �❑ Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 L❑ 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•,•••,,••,•••,,, )06 ^ 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 5b
c. Heating, air conditioning..........
d. Other (elevator, etc.).............
11. TOTAL COST OF IMPROVEMENT L$ 7
�a '"
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 ❑ Masonry (wall bearing) 40 Public or private company 48• Number of stories................
31Wood 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 — .Specify42 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 1. TYPE 0 MECHANICAL 51. Enclosed .......................
35 ❑ Gas Will there b central air 52. Outdoors........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 LA' Electricity 44 ❑ Yes 45 ❑ No
-- 53. Number of bedrooms..............
38 Coal
39 I❑ Other — Specify Will there be n elevator? Full..........
54. Number of
46 Y s 47 ❑ No bathrooms
Partial.......
f
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ` ZIP code Tel. No.
1. ! f, 0/0 4V
Owner or
Lessee
Builder's
2 License No.
Contractor
3. `CC
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.
Al
Signat f applicant Address Application date
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 $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obta ned 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 r "—'1 _ FOR DEPARTMENT USE ONLY
Permit number -�
Bul Iding• Use Group
Permit issued 19 g3
Building Fire Grading
Permit Fee $ � � Live Loading
Certificate of Occupancy $ Occupant Load
pr ved by: �
Drain Tile $
Plan Review Fee $
TITLE
NOTES and Data — (For deportment use)
Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
FRONT YARD
SIDE YARD SIDE - r
REAR YARD
IX. SITE OR PLOT PLAN For Applicant
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