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29-089 (3) PERMIT APPLICATION CHECK LIST PAS = T' ZN NO DATE 14W �11 JEM LIC , # IF NOT 3 SET., OF- PLANS PLAN 5 , NEW CONSTRUCTION 6 . CURB CUT 7 . WATER S 8 , REMODELING 9 . ADDITION 10 , ACCESSORY STRUCTURE 11 , SIGN AWNING 1 2 , PERMI FEE - MONEY 0 DE' 13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE 14 . UNDER SECTION 127 - C R 780 15 . FORM A 16 . FILL COMMENTS . i . 4�KpT goo o a$ GX f' of xarf 4all 1pf an DEPARTMENT OF BUILDING INSPECTIONS - INSKCTOR 212 Main Street ' Municipal Building 'y� Northampton, Mass. 01060 HOMEOWNER LICENSE EXEMP`.PION (Please Print) DATE: �� 3 ''g 3 . JOB LOCATION- (Ma ) ,(Parcel) (Subdivision) HOMEOWNER: (Name & Address) (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 ' h. 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 BUILDING PERMIT # x � `C3 C n 0 m p Orri `-; Z a _ B u) o fD Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations a NORTHAMPTON, MASS. 19 Additions APPLICATION FOR PERMIT TO ALTER Repair Garage 1 Location FL o r e Acct^ Lot No. 2) Owner's name E JZ 4 �(� P %/��Address-2 .2 r //�r�G(,� oo X F L clew cli 3. Builder's name Address Mass.Construction Supervisor's License No. _Expiration Date 4. Addition 5. Alteration A _ 6. New Porchrt 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. Skiing house 4. Espmated cost:- ��S d'. oU The undersigned certifies that the above statements are true to the best of his, her �� knowledge and belief. �r c Signature of responsible app,icant Remarks _ M Date Filed File No. ZONING PERMIT APPLICATION (910 . 2) 1. Name of Applicant: Address : vtZ k Telephone; 2 . owner of Property: r d Address : J) BrI h Telephone: F 3 . Status of Applicant: e-�wner Contract Purchaser Lessee Other (explain: ) 4 . Parcel Identification: Zoning Map Sheet# ;tq Parcel# , Zoning District(s) (include overlay,,) ((-4 Street Address 2-Z Required 5. Existing Proposed by Zoning Use of Structure/Property (if project is only interior work, skip to #6) Building height %B1dg. Coverage (Footpr ' t-� Setbacks - front - side R: - rear Lot size Frontage Floor Area Ratio %Open Space (Lot area nil nus building and parking) Parking Spaces Loading Signs Fill (volume & location) Narrative Description of Pro osed Work/Projec : (Use additional sheets if necessary) 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 . � s Date: !Z,��;-; 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 : nding qu ' ed: _ Variance Required : na e f Bu ' Inspector t 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 the Board of Health, Conservation Commission, Department of Public Works and other applicable permit granting authorities. C) �*• ,�'o o j....j v' 6 .y.: ° ~' z o cD p O rq I"ft �°•n � coCDg o ° v� cu 8 rn CO OD ol b m C9 p. fy N 0 5 b 03 Cn N O O 0- La R d � � IQ c t' m n 0 c 0* .-qQ p 5, a x 0� 50 5 OrQ 5' ` LO eD c y � � o � r � � bd55 y ro gg o r"3 .y dq p O OFS LA) 5' 5 °� o b ro got Uq QY O 5 5 by ° *� A (� cp 'i7 v� p �. 5 �n 7d ' ►� ❑ N g ° o G A �. G �• C. O p. � �••� o '' ►; fir° °�° Lei 5 y d OQ CL © � OD