35-078 (5) ' S
PE-RIYUT APPLICATION CHECK ST
G "J� 0 '� ES NO DATE
ZONING C 0 �--
2 . PERMIT APPLICATION
3 . OWNER OCCUPANT STATEMENT / LIC , II IF NOT
r
3 SETS OF PLANS /PLOT PLAN
5 . NEW CONSTRUCTION
0 . CURB CUT
7 . WA19B AVAILABUITY FORMS
8 . REMODELING INTERIOR
9 ADDITION
0 STRUCTURE
11 , SIGN AWNING
2 , PERMIT FEE - CHECK ONLY dONEY DE -:k
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPI.TCABLE
14 , UNDER SECTION 2 -- CdR 780
15 . FORM A
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' DEPARTMENT OF BUILDING INSPECTIONS �
INSPECTOR 212 Main Street ' Municipal Building '
Northampton, Mass. 01060
HOMEOWNER LICENSE EXEMPTION
• 9� (Please Print)
DATE: r �j
JOB LOCATION•
(M p) (Pa cel) ( Subdivision)
HOMEOWNER:
,,, e dglrr�-� S�Y Y SYZ
(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 SIGNA f�X�
BUILDING PERMIT #
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Additional 4200 ft. k
excluded 1992
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RYAN RD
Forest Cover Type & Boundary Pap for s C R J-E �f = 2 00'
NORTNAMPTO1l, M Property of V'
LEGEPdD
Charles A. Miller
876 Ryan Road T•t'• Iron Pin � _._ - Tlrook
Northampton, MA 01060 _�- � Barbed Wire Nw- S;ramp
Prepared by Bay State Forestry Service •/'- Forst Type
from Poundary
Davis EnglcT orf ng- CO. Survey 9/30/49
June 14, 19B2
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
a NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
/ 1�1 , /� Garage
Location rB' < �/1 Sl *� / Lot No. '!
. Owner's name G1 4,eze-15' ooi f&f Address
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration D to
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
ft�
14. Estimated cost:- h
CJ
The undersigned certifies that the above statements are true to the best of his, her
knowle e
Signature of responsible app,icant
Remarks
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Date Filed '' 0 0120,;
File No.
ZONING PERMIT APPLICATION (910 , 2 )
I . Name of Applicant: CIV'It.e1PS , /� , �(e,2
Address :_ 1?6F ;,g,,, kcV Telephone : SAY-r7d�Y
2 . Owner of Property: cGta.?ZeS fr/l—K
Address : F''7 d dP��w aF'ol lor�Pti«� /YID Telephone : 3 y- e'/a
3 . Status of Applicant : Owner Contract Purchaser
Lessee --other (explain : Sofy T- y� )
4 , Parcel Identification : Zoning Map Sheet# 3J Parcel# '/ ,
Zoning District (s (incl d erlay
Street Address ) � ,
Required
5 , a Existinq Proposed by Zoning
Use of Structure/Property SAed
(if project is only interior work, skip to #6 )
Building height
B1dg. Coverage (Footprint)
Setbacks - front Q
- side L: R: L: V30, R: c�
- rear
t size
Frontage oNe
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)
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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 : 6'_3 -93 Applicant's Signature :
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as'presented--Reason :
Special' Permit and/or Site Plan Required :
i i n g wired : _ Variance Require _
�Bu i ector Dat g
NOTE: issuance of a zoning permit does not relieve an appifcnni's burden to comply with nil zoning requirements and obtaln all required permits
from the Board of Hoallh, Conservation Commission, Depnrlrnonl of Public Works and other npplicnbla permit granting nuthorilios.
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