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NOTE:IN ORDER THAT THIS APPLICATION MAY BE ACCEPTED,THE DATA CALLED FOR BELOW MUST BE SO SET FORTH
THAT WE CAN DETERMINE FROM THE APPLICATION AND THE ACCOMPANYING PLANS WHAT THE EXISTING CONDI-
TIONS ARE AND WHAT THE FUTURE CONDITIONS WILL BE.
Plot Plans and Plane,must be filed with this application before a permit be granted.
Zone
APPLICANT NOT TO FILL IN SPACES ABOVE THIS LINE
Application for a Dwellin Permit
g t tie Northampton,Mass. . . . . . . :7� a. /. . . . . 19
Telephone No. . . . . . . , �� . . . . . . . . .
7b the Supt.of Buildings:
Application for a permit to build is hereby made according to the following:- f
1. Location, Street and No. .f9 0?5.F S . .9/l. .R.o.!}�. . . . . . . .l�. '.�?� f
. . . . . . . . . . . . . . . . Lot No. . . . . . . . . . .
2. Nearest cross street . . . . . . . . .�LC'e��C.... . . .uf. . . Size of lot . . ../.�/. .7 .! . . . . . . . . . . . . . ....... . . . . .
3. Owner's name . . . .. TIH`. . .. .. . . . . . I�SL Address . .1 ./`f//If CLE ., `ST�i. . . . . . . . . . . .
4. Architect's name ./4V.Gv.S T�[15. . J,(��GlL�/4 . . . . . . . . Address .L.�n!4._Z. AIWA- All . .1.t.5 .16. . .
5. Builder's name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Mass. Construction Supervisor's License No. .. . . . . . . . . . . . . . . . . . .. . . . .. Expiration Date . . . . . . . . . . . . . . . .. . .. . . . . .
6. Use of Building:One-family . . . . . . . . . . . . . .. Two-family . . . . . . . . . . . . . . . . . . .. Other . . . . . . . . . . . . . . . . . . . .
7. Number of rooms in each family unit: . . . . . .�. . . . . . . . . . . . . . . Number of Bathrooms . . . . . . . �. . . . . . . . . . . .
8. Is there a garage attached? .
9. Size of building 7.4:-q. X3J.-6.; .>U.9:7�. . . . . . . Square footage, a�5.�.f.6 A� E O?• D/'. .
10. Number of stories . . . . . . . . . . . . . . . . . . . . . . . . . .t. . . . .. . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . .
11. Distance from finished grade to high point of roof . . . . . . . . ?. . . . .°. . . . . . . . . . . . . . . . . . . . . . . . . .
12. Type of construction . . . . . . . . . ./,).O o. . . . . . . . . . . . . . . . .. . . . . . . . .. . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . I . . . . . .
13. Distance from building to street line in feet . . . .. . rj . . %�. . . . .� . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . .
14. Distance from building to side lot lines in feet:Left . . . . . . . . . . . . flight . . . . .�30 ..
J(�
. . . . . . . . . . . . . .
15. Distance from building to rear lot line in feet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16. Is a plot plan being filed with this application? . . . . . . . . . . . . . . . • • • • • • • • . . • • • . • •
S v. . . . . . . .. . . . . . Other . . .. . . . . .. . . . . . . . . . .
17. Species of framing lumber:DF . . . . .. . . . . . . . . . . . . . Spruce . . .
p
18. Are all structural conditions noted on drawings? . . . . . . . . . . .
19. Nature of land upon which the structure will be erected:Natural d,.vy. . . . . . . . . . . . Filled . . . . . . . . . . . .... . . . . .
20. Depth of basement or cellar floor below finished grade . . . . . . . . . . . . . . _ • • • • • • • • • • �r
21. Material of foundation walls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Thickness in inches . .. . . . .
22. Type of roof:Flat . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . Pitched . 1//. . . . . .. . . . . . . . . . . . . . . . . . . . .. . . . . . .
23. Material or roof covering . . . . . . .A_�5 PIA4 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . .. . . . . . .
24. Method of heating . . . . . . . . . . . . . . .0 /.L . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . .
25. Will the building conform to the Building and Zoning Ordinances? . . . . . . .
26. Septic Tank? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . City Sewer? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
27. Construction within 100 ft.of wetlands? . . . . ....;
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
28. Construction within 100 year flood plain? . . . '"''�
29. Estimated cost:Total $ . . . . .(J`,�t�.�!�'� N` .
No building or structure which is erected or altered,shall be used,in whole or in part,for any purpose until a certificate
of occupancy is issued by the Building Inspector.
The undersigned certifies that the above statements are true to the best of his knowledge and belief.
JK. . �ill`?�s�! uf
. . . .Signature of Contractor Signature of responsible applicant
WRITTEN DESCRIPTION OF WORK TO BE DONE
. . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .
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� �IT7.
�04� PTOj CITY OF NORTHAMPTON, MASSACHUSETTS
a DEPARTMENT OF PUBLIC WORKS
$ e 125 Locust Street
Northampton, MA 01060
Samuel B. Brindis, P.E. 413-582-1570
Director, City Engineer
Peter J. McNulty, Sr.
Assistant Director of Public Works
BOARD OF PUBLIC WORKS
DRIVEWAY PERMIT
GENERAL N TRU .TTONS AND REGULATIONS
ATIONS
1. A "Driveway Permit" is required in all cases where a new
curb cut or an alteration to an existing curb out is
proposed on a city public way.
2. Driveway permits issued by the Board of Public Works (BPW)
shall be attached to and become part of the "Building
Permit" issued by the Building Inspector.
3. Prior to the issuance of a "Building Permit" the owner of
any lot to be serviced by a new. driveway shall apply to the
B.P.W. for a "Driveway Permit" by completing the pertinent
portions of the permit (see attached) . Once the location of
the driveway is approved by the BPW, a building permit may
be issued.
4. The Building Inspector shall issue no "Occupancy Permit"
unless the driveway to the lot has been approved by the BPW.
5. By the issuance of a driveway permit for the stated
location, neither the City of Northampton nor the Department
of Public Works imply that no drainage problems will result
with the driveway when constructed. Properties situated or
driveways installed in low lying areas in the path of the
natural drainage will be subject to water problems. These
problems may include water sheeting across roadways adjacent
to the driveway. The City and the DPW assume no
responsibility for any such drainage problems. The owner of
the property is responsible for constructing and maintaining
the driveway with adequate provision for natural water
runoff situations.
Samuel B Brindis, P.E.`
Director of Public Works
6:P`1\,S-_,A1,1 L,R`vIAY.PER
Conditions: Driveway Permit
In lieu of plan approved by City Engineer
I agree to the following added conditions:
1) I will contact the Department of Public Works and have
an inspector check and approve the graded gravel base
prior to paving to insure compliance with slope and
location;
2) I further agree that if in the inspections any of the
permit conditions are not met that I will at no expense
to the City remove and replace the driveway as directed
by the City Engineer.
By: `�KIYd
Pe itioner"Frank Dombrowski
NOTE: The Public Works Department recommends that you provide a
plan showing the proposed driveway with grades and location
in the future to avoid possible expense which you will incur
by not getting approval of actual plans in advance.
C I TY OF NORTHAMPTON, MASS.
May 28, 19 93
THE BOARD OF PUBLIC WORKS
The undersigned respectfully petiition your honorable body for
Permission to install driveway at 620 Burts Pit Road
Fifteen (15) foot maximum width at the street line. Gutter drainage not to be
disturbed. All drainage shall be directed off the driveway surface to
adjacent land and not on the existing roadway. Driveway surface to be
paved if the grade of the proposed driveway exceeds 3% or more.
By• A ��
Frank Dombrowski 586-0528
Proposed Location
Inspected by:
Gravel Base Grade !
Inspected by:
Final Approval:
THE BOARD OF PUBLIC WORKS
Voted that petition be granted.
$25.00 Fee Paid ✓ ek #0
Samuel B. Brindis, P.E. , Director of Public Works
(SUBJECT TO ATTACHED CONDITION 1 & 2)
X 5511
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NORTHAMPTON WATER DEPARTMENT
237 PROSPECT STREET WAU
NORTHAMPTON, MA 01060
586-6950 Ext. 300
Subject: Municipal Water Availability
t
Location: 620 Burts Pit Rd . -
Inquiry Made By: Frank Dombrowski
Date of Inquiry: 5-24-93
Municipal Water Main in Front of Location: YES X NO
Size/Material/Age of Water Main: 12" DI 1978
Approximate Street Pressure: 35 PSI
Size of Service Connection: ?
Comments: Low pressure area
A corresponding "water entrance fee" shall be paid prior to making
any connection to the municipal water system. Arrangements of such
installation shall be made with the Northampton Water Department
with a minimum of 5 working days notification. All work shall
conform to Northampton Water Department specifications.
Charles Borowski
Superintendent of Water
Enclosure: Letter to Frank Sienkiewicz from Sam Brindis, dated
June 14, 1991.
cc: Samuel B. Brindis•`, Director, DPW
Peter McNulty, Jr. , Assistant Director, DPW
George Andrikidis, Assistant City Engineer
Frank Sienkiewicz, Building Inspector
C: \Forms\CityH2O
t v
Date Filed_ e ern u 1 cC1 File No. a.9 -
ZONING PERMIT APPLICATION (§10. 2) S p
1. Name of Applicant: crank. Qnd V,e_0o pm�2�uw5 i �l
Address: 35 LftnCklcu S�JVd2rNnmoio!� NATelephone:,5",F6 -d5,;�
2 . Owner of Property:Ji y icl ffl a Sac n�e
Address: Telephone:
3 . Status of Applicant: Owner Contract Purchaser
Lessee ✓ Other (explain: e ;f- RuJAMQ r i "
4 . Parcel Identification: Zoning Map Sheet# 24 Parcel# _,
Zoning District (s) (include overlays) 52
Street Address T3 oa-d 2 ton
Required
5. Existing Proposed - bv Zoning
Use of Structure/Property __Rle i de ncv_
(if project is only interior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side L: R: L: R: D '+ 2.0 l
- rear
Lot size x `71
Frontage '7
Floor Area Ratio u
%Open Space (Lot area minus
building and parking) urtkvn n
Parking Spaces
Loading
Signs
Fill (volume & location)
6 . Narrative Description of Proposed Work/Project: (Use additional sheets
if necessary) --fe) r cfi 6t 1' n th a 4-6) L
F - 4)0 b rzl Wi n q S aff 0.2 Qi I a 121 e ktl
� m
7 . Attached Plans : Sketch Plan
ite Plan
8 . Certification: I hereby certify that the information contained hfrein
is true and accurate to the best of my knowled
Date CA : � (�f� `cam Applicant's Signatur �
,r-
_ _ _ _ _ _ _ _ _ _ _ _ - - - - - -
- - THIS SECTION FOR OFFICIAL USE ONLY: DEC 1 512
�3
/Approved as presented/based on information presented
Denied as presented--Reason: P901 QE 20 ,
Special Permit and/or Site Plan Required:
finding equired: variance Required:
i.gnat of B g nspector Date
NOTE: ance of a zoning permit does not relieve an applicant's burden to comply with all zoning requirements and obtain all required permits
from the Board of Health, Conservation Commission, Department of Public Works and other applicable permit granting authorities.
1
of 'No tij amptall
9 9
mass X(hu,rtt•
6 Office of tfte �nsperfor of ?Auilbinjis
212 Main Street •Municipal Building
Northampton, Mass. 01060
CERTIFICATE OF OCCUPANCY
36 287
November 13, 1995 Page No. 29 _ Plot 4
Wilding (Name) Single family home/attached garage Address 620 Burts Pit Road
)wner Frank & Loretta Dombrowski Address 35 Hinckley Street
�pplicantSAME Address
)se: 1st Residential Occupancy
2nd Occupancy
3rd Occupancy
4th Occupancy
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