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" - DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building '
Northampton, Mass, 01000 M ,,
HOMEOWNER LICENSE EXEMPTION
(Please Print)
DATE• Z�
J
JOB LOCATION: �' v' Z, v
(Map) (P rc 1) Sub ivi ion)
HOMEOWNER• ✓
(Name & Address)
(Home Phone) (Work Phone )
The current exemption for "homeowners" was extended to include
Owner-occupied Dwellings of six ( 6 ) units or less and to allow such
homeowner to engage an individual for hire who does not possess a
license, provided that the owner acts as supervisor.
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 to six 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
r
General Laws Annotated.
HOMEOWNER SIGNATURE Z".
BUILDING PERMIT #
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. � U �. Alterations A
NORTHAMPTON, MASS.
a 19 Additions h
Repair
APPLICATION FOR PERMIT TO ALTER Garage
1. Location Y'- it Lot No.
2. Owner's name `M Address T 3 (11'' �
3. Builder's name Address
Mass.Construction S rvisor's License No. Expiration Date
4. Addition 4 , `i
5. Alteration
6. New Porch
7. Is existing building to be demolished? Q
8. Repair after the fire 1n O
9. Garage " 1) No.of cars Size
10. Method of heating b1A-
11. Distance to lot lines K A.
12. Type of roof �)A
13. Siding house
14. Estimated cost:-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible applicant
Remarks—
PR
IN. TnSHOP
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Date Filed ' 7 File No.
ZONING PERMIT APPLICATION (§10 . 2)
1 . Name of Applicant: JA '(� ' FMS
Address : ,6a- Telephone: - to
2 . Owner of Property: 'SIN
Address : 41 / Telephone:
3 . Status of Applicant:--kowner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# 31 A Parcel# Z69 ,
Zoning District (s) (include overlays) U RA.
Street Address
Required
5 . Existinq Proposed by Zonin
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side
- rear
Lot size
Frontage
Floor Area Ratio
%Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6 . Narrative Descr ion of Proposed Work Project: (Use additional sheets
Lgecessarv)��n s ��Iv)K vr�w� C� ) ZX 4- FY444.)5r c, �
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: � f Applicant ' s Signature:
- - — — — — — — — � `f - — - — -
THIS SECTION FOR OFFICIAL USE ONLY: lA ; _
AUG 4
/Approved as presented/based on information presented
Denied as presented - -
Reason r D ial:
' 0`� 'AUG n z look
Signature of Building Ins or Date
NOTE: Issuance of a zoning Pe 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.
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