36-099 (8) Vill. ZONING PLAN EXAMINERS NOTES
DISTRICT
E.
REAR YARD
IX. SITE OR PLOT PLAN For Applicant Use
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NOTES and Data — (For department use)
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IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, street, city, and State ZIP code Tel. No.
owner or
Lessee
Builder's
Z, 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
Pi r G i- ec a
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
9 Fee Started y Approved y
BUILDING $
PLUMBING $
MECHANICAL $
ELECTRICAL $
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Permit or Approval Check Obtained Number By Permit or Approval Check Obtaatned 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 /s FOR DEPARTMENT USE ONLY
Permit number L�
Building Use Group
Permit issued 19
Building Fire Grading
cif)
Permit Fee $ Live Loading
Certificate of Occupancy $ Occupancy Load
Approved by ��J°"'""'S
Drain Tile $
Plan Review Fee $
TITLE
` CITY OF NORTHAMPTON
�. MASSACHUSETTS
$ OFFICE of the INSPECTOR of BUILDINGS
Page Plot of APPLICATION FOR
INSPECTOR ZONING PERMIT AND
BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING
I• AT (LOCATION) /� -/I PJ Road- D STR CT C!
LOCATION Y ((NO..)�) (STREET) y
OF BETWEEN i ��f�/Cc Rck AND ti Coy
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D ;0
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
m
—f
1 ❑ New building Residential Nonresidential
2,;�5 Addition(If residential, enter number 12 family 18 ❑ Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 wo or more family — Enter 19 Church, other religious
number of units— — — — __)0- 20 ❑� Industrial
3 ❑ Alteration (See 2 above) r
14 ❑ Transient hotel, motel, 21 1� Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (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 — Specify 25 ❑ Public utility
7 ❑ Foundation only 26 School, library, other educational
B. OWNERSHIP
27 Stores, mercantile
—����� L� z
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................ ,7 school, secondary school, college, parochial school, parking garage For.
department store, rental office building, office building at industrial plant.
7'o 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 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
30 ❑ 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, 17 /
all floors, based on exterior �� y
32 ❑ Structural steel dimensions ..................... ifl4
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY t
34 ❑ Other — Specify 42 L❑ Public or private company 50. Total land area, sq. Ft. ........... ��':
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
er
37 C� Electricity 44 [—] Yes 45 i'7 No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevators Foll..........
54. Number of
46 [—] Yes 47 lD No bathrooms
Partial........
a DEPT. OF BUILDING INSPECTIONS BUILDING Z°
212 Main Street 'a C,, 10"1,)6
Northampton, MA 01060 PERMIT a �;
36 - 99 o VALIDATII ON
DATE July 22, 19 87 PERMIT NO. 482
APPLICANT Ed Popielarczyk ADDRESS 98F uFs—Pit Road, Florence Owner
(NO.) (STREET) (CONTR'S LICENSE)
Addition porch NUMBER OF
PERMIT TO (�) STORY p DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
AT (LOCATION)
981 Burts Pit Road, Florence ZONING
DISTRICT URA
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION 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, permit for the addition of extra porch area onto existing porch
VOLUME 1 1 9 sq• f t• PERMIT
ESTIMATED COST � 8'550.00 FEF,, .$_ 10.00
(CUBIC/SQUARE FEET) _
OWNER Same as Applicant
ADDRESS Same as Applicant's eYILDIN ''st,-- F
s
WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY po.Nfp