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17A-121 (3) ZONING • DISTRICT FRONT YARD 1) SIDE YARD SIDE YARD _/5 REAR YARD NOTES IX. 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IDENTIFICATION — To be completed by all applicants Name Mailing address — Number, street, city, and State ZIP code Tel. No. j[//�� t ,�J d � � ,V' Owner or t/V� �(� G t f/i .� /TVdV- �c e-- / v Lessee �D LI^ 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. Signature of applicant Address Application date C14rP(f 7/0 P'r- c DO NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Required Check Plan Review Date P y Plans B Date Plans By Notes Fee Started Approved BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL Is OTHER Is V1. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approval Check Date Number By Permit or Approval Check Date Number B Obtained Obtained 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 I 7 Use Group Permit issued 19 Building Fire Grading T, oc-) Permit Fee $ Live Loading Certificate of Occupancy $ Occupancy Load Approved by: , lu Drain Tile $ gUf/ Plan Review Fee $ TITLE CITY OF NORTHAMPTON 9• g MASSACHUSETTS $ f OFFICE of the INSPECTOR of BUILDINGS T Page — Plot APPLICATION FOR ZONING PERMIT AND INSPECTOR BUILDING PERMIT z IMPORTANT — Applicant to complete all items in sections: I, 11, 111, IV, and IX. 0 I• AT (LOCATION) ZONING DISTRICT LOCATION (NO') (STREET) OF BETWEEN �1 00 6k: ' `� AND BUILDING (CRO55 STREET) (CROSS STREET) Q LOT SUBDIVISION LOT 1 BLOCK SIZE II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D A A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m m 1 F__1 >d<building Re 'dential 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� Church, other religious number of units— — — — 20 Industrial 3 Alteration (See 2 above) 14 l l h �l Transient hotel, mote , u 21 Parking garage 4 Repair, replacement or dormitory — Enter number 5 ❑ Wrecking (If multifamily residential, of units ——————— — --> 22 n Service station, repair garage enter number of units in building to 15 Garage 23 Hospital, institutional Part D, 13) 24 Office, bank, professional 16 L� Carport 6 Moving (relocation) 25�� Public utility 17 �� Other — Specify 7 Foundation only 26 School, library, other educational B. OWN SHIP / 27 Stores, mercantile 8 Private (individual, corporation, 28 Tanks, towers nonprofit institution, etc.) 29 Other — .Specify 9 D Public (Federal, State, or local government) C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food /tv processing plant, machine shop, laundry building at hospital, elementary 10. Cost of improvement•,,,•,,......... i! 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.)............ it. TOTAL COST OF IMPROVEMENT I$ 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[_1 Masonry (wall bearing) 40 Q Public or private company 49 31 ood frame 41 r� Private (septic tank, etc.) . Total square feet floor area, all floors, based on exterior 32 Structural steel dimensions ..................... 33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY Public or private company 50. Total land area, sq. Ft. .......... 42 34 � Other — Specify �� p 43 Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed ....................... F. PRINCIPAL TYPE OF HEATING FUEL 1. TYPE OF MECHANICAL 35 Gas Will there be central air 52. Outdoors........................ 36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37 Electricity 44 F]] Yes 45 Nc 53. Number of bedrooms.............. 38 Coal 39 Other — Specify Will there be an elevator? 54. Number of Full.......... 46 1 Yes 47 J No bathrooms Partial....... a DEPT. OF BUILDING INSPECTIONS BUILDING ! 212 Main Street 04 ►'r I IL Northampton, MA 01060 PERMIT 17A - 121 VALIDATION DATE August 18, 19 87 PERMIT NO. 556 APPLICANT Mike & Helaa Rn,vle ADDRESS 54 Claire Ave. . Florence Owners (NO.) (STREET) (CONTR'S LICENSE) NUMBER OF PERMIT TO Add i t i nn (_) STORY Deck DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ZONING URA AT (LOCATION) 54 Claire Ave. . Florence DISTRICT (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE DuEuCy(K )ORYFIYK4X uy q IS TO BE 15 FT. WIDE BY .L-2-FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS; nArmit fnr thin ariditinn of a dpCk nntn roar of Pxicting dwelli�n AREA OR 180 sq. f t. ESTIMATED COST 800.OO FEEMIT $ 10.00 VOLUME (CUBIC/SQUARE FEET) OWNER BOIL ADDRESS Sam@ as AppliGaPFt' S BY WHITE - FILE COPY . GREEN - FIELD COPY • CANARY ^ APPLICANT COPY • PINK SSESSORS COPY p f P