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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
a NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
r
Garage
1. Location ��3 fs',.c° �, f ,��., �/ Lot No.
2. Owner's name _T��,�r ��r9-s ._� Address....z--?,/: 3
3. Builder's name /01� ,
Address 1-3",3 ',refs f .tc;>e,
Mass.Construction Supervisor's License No. Expiration Date
4. Addition /
5. Alteration 5 c ""-241V,e-7`
6. New Porch
7. Is existing building to be demolished? Wit)
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-
The undersigned certifies that the above statements are true to the best of his, her
knowled and belie
Signature of responsible appicani
Remarks
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DEPARTMENT OP BUILDFNG INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building"
0.
Northampton, Macs. 01060
HOMEOWNER LICENSE EJCEI*SPTION
(Please Print)
DATE:
z
JOB LOCATION: 133
(Map) (parcel ) ( Subdivision)
HOMEOWNER: /i 744 ,
(Name & Address )
s
1?711 361 V91
(Hon--e Phone ) (Work Phone )
The current exemption for "homeowners" was extended to include
Owner-occupied D•,aellings of one ( I )or two (2) i=ami 1 ies and to allow such .
homeowner to engage an individual for hire who does not possess a `
license , provided that the owner acts as supervisor . LrIR780 Section 109. i . i
DEFINITION OF Person(s ) who own a oarce 1 of land on
which he/she resides or intends to reside , on ' 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 homeoigner . 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
m
will be required frotime to time , during and upon completion of the
work for which this permit is issued .
Also be advised that with reference to Chapter 1S2 (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 Loc 1 Zoning Laws and• State of Massachusetts
General Laws Annotated M6/SHAL E ON THE JOB AS SUPERVISOR.
t
HOMEOWNER SIGNATURE
BUILDING PERMIT (;
i
10. Do any signs exist on the property? YES NO
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO__4_-- -
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This color to be filled in
by the Building Dtiepartmeat
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L: R: L: R: /C9
- rear
Building height
Bldg Square footage
%Open Space:
'(Lot area minus bldg
&paved parking)
# of -Parking Spaces
# of Loading Docks
Fill:
'_(vol-ume--& location)
13 . Certification: I hereby certify that the info ation jcoained herein
is true and accurate to the best of my know e ge.
DAVE: 205 APPLICANT's SIGNATURE
NOTE:1 uan'oe of a zoning permit does not relieve a applioant' `burden to oomph with all
zoning requirements and obtain all required permits from theard of Health, Conservation
Commission, Department of Publio Works and other applioabl permit granting authorities.
:?'' FILE #
Fi 1 e No.2 0-)
1
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TY/P;�E OR PRINT ALL INFORMATION
1. Name of Applicant:_
Address: Telephone:_ ; �—361Y</
2. Owner of Property: ,a A,.-)X
Address:1-3/ Telephone: ; L: - 3
3. Status of Applicant: Owner, — Contract Purchaser Lessee
Other(explain):
4. Job Location: ,i?e'13
Parcel Id: Zoning Map# Parcel# District(s): U
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use o Structure operty
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special Permit/Vadance/Finding ever been issued for/on the site?
NO DON'T KNOW YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES
IF YES,has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained ,date issued:
(FORM CONTINUES ON OTHER SIDE)
FILE # j �
7 ,
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE:
PROPERTY LOCATION:
MAP PARCEL: 171 ZONE ,'
THIS SECTION FOR-OFFICIAL USE ONLY:
PERK HT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM M.T.Fl) OUT
Fee PRid
BiTilding Permit Filled n1vt
Fee Pnifi
lRerundelin2 Interior
Addition t�Ryktin2 6; a
of Pinns /Plot Plan
OLLOWING ACTION HAS BEEN TARN ON THIS AP ICATION- `
Approved as presented/based on information presented
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under:§ w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
Permit from Conservation Co ission
Signature of Building Inspect Date `
NOTE:lasuanoo of a zoning permit does not relieve an applionnt's burden to oomply with all
zoning requirements and obtain ail required permits from the board of Health, Conservation
Commisslon, Department of Pubiio Works and other applioabie permit granting authorities.
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