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37-016 PERMIT APPLICATION CHECK LIST , ^ ^� • ` DATE'37 PLOT 4 ZONE � / � �� *<�- YES NO ^ 1 . ZONING FORM APPLICATION "- 0,:? 2 . PERMIT APPLICATION L ^ '- , ^• ' 3 . OWNER OCCUPANT STATEMENT / LIC . # IF NOT (--- 4 . 3 SETS OF PLANS /PLOT PLAN 5 . NEW CONSTRUCTION G . CURB CUT 7 . WATER AVAILABILITY FORMS 8 . REMODELING INTERIOR S . ADDITION 10 . ACCESSORY STRUCTURE 11 . SIGN / AWNING � 12 . PERMIT FEE ONLY - MONEY ORDER, ,, /1 �^�� ^~ 13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE _ 14 . UNDER SECTION 127 - CMR 780 . 15 . FORM A 16 . FILL COMMENTS : .-- �� _�/,� �� � I Yt—a-rJA;ZZ" d ` /7 /y ° �/ ": 9 XJ `d .. ;< 1• C ►ti .ti = a r B. 7 C 0 tll n, "i O R b --3 0 rn z, r Z O -t Z a. 5 cn O v y g. -1 1� L/� Zoning Miscellaneous Additions,Repairs,Alterations,etc. SEPT-l.No.'.3 4 —t cQ K Alterations az" ° ti NORTHAMPTON, MASS. V c?a 19K3 Additions inrM '.,! ** , APPLICATION FOR PERMIT TO ALTER Repair P/. Garage I. Location '741? /�L ,p O/1 E./�C E I L Lot No. 2. Owner's name /17 4RY 4 01) C OR T/S Address 74(9 TLO,11E 'Ck. RD 4 T/MAMPT4' 3. Builder's name Address Mass.Construction Supervisor's License No. Expiration Date 4. Addition 5. Alteration 6. New Porch 7. Is existing building to be demolished? ,.. 8. Repair after the fire 9. Garage No.of cars Size 10. Method of heating 11. Distance to lot lines 12. Type of roof 13. Siding house 14. Estimated cost:- 4bo c,1 O0 �: The undersigned certifies that the above statements are true to the best of his, her *(Z) knowled e and belief. ate..., Cwitzitv CIA Signature of responsible applicant Remarks A pha 17 Shin ies aIs �/// Ie used ,cove r eXis 1/ q s4/ray/e .5 di"T1WipT ==*emu 1t t.e��% �Ll e (!ri rf Nrfrf I atp f o t �0.c..rs tt t ,- i_ DEPARTMENT OF BUILDING INSPECTIONS A _t=� ;' INSPECTOR 212 Main Street ' Municipal Building Northampton, Mass. 01060 _',‘. HOMEOWNER LICENSE EXEMPTION Please Print) DATE; SEPT✓ e73'j /9R.. . JOB LOCATION: 37 `" (Map) (parcel) (Subdivision) HOMEOWNER: /41,4"0/ 40 U C, V A'TAS (Name & Address) 7Y? fLoRk 'ck" ib Dr47-f%4JP7 2#' -"F1-do?X5 (Home Phone) (Work Phone) The current exemption for "homeowners" was extended to include Owner-occupied Dwellings of one (1 )or two (2) families and to allow such . homeowner to engage an individual for hire who does not possess a ' license, provided.. that the owner acts as supervisor. CMR780 Section 109.1 .1 DEFINITION OF HOMEOWNER: Person(s) who own a parcel of land on which he/she resided or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/or farm structures . A person who • constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he/she - shall be responsible for all such work performed under the building permit. As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon completion of the ;` work for which this permit is issued. Also be advised that with reference to Chapter 152 (Workers ' Compensation) and Chapter 153 (Liability of Employers to Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be" liable for person(s) you hire to perform work for you under this permit. The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of Northampton Ordinances, State and Local Zoning Laws, and State of Massachusetts General Laws Annotated. HOMEOWNER SIGNATURE C%M ■ 0422.&4; _ BUILDING PERMIT # , • 0.si\YA. 4 Date Filed YA:03 File No. ZONING PERMIT APPLICATION (§10 . 2) 1 . Name of Applicant: ,4 Y LOU CU/4/1S Address : 711S"/t4ORrNCEeD 4/0/77764Wpnw Telephone: -Da - 2 . Owner of Property: MARY ,L,O ) 60/5777S Address : J 8FkO/P,EiYcjRD /YDRT/y/f/j//'7 ' Telephone : "ey_Dam 3 . Status of Applicant: //Owner Contract Purchaser Lessee Other (explain: 4 . Parcel Identification: Zoning Map Sheet# 3 7 Parcel# Zoning District (s) (include overlays) Street Address 2L 4 Required 5 . Existing .9 Proposed by Zoning Use of Structure/Property AO-de-42 C,C (if project is only interior work, skip to #6) Building height %Bldg. Coverage (Footprint) Setbacks - front - side L: R: L: R: - rear Lot size Frontage Floor Area Ratio %Open Space (Lot area minus building and parking) Parking Spaces Loading Signs Fill (volume & location) 6. Narrative Description of Proposed Work/Project: (Use additional sheets if necessary) PP f- Qspha/74 Sh/i /PAS Over E:X2s76/sif Shii�oVF.ls rY V 7 . Attached Plans : Sketch Plan Site Plan 8 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge . Date : Jeff 43 /7 -q Applicant's Signature : / THIS SECTION FOR OFFICIAL USE ONLY: v Approved as presented/based on information presented Denied as presented--Reason: ,pecial' Permit and/or Site Plan Required : din. equired: Variance Required: /100Fr S gna .-re of Bu ' '---: -- :r � Da e NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning requirements and obtain all required permits from tho Board of Health, Conservation Commission, Department of Public Works and other applicable permit granting authorities. n N z ai ago g.g. C 4.ao.,y. 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