29-465 (4) PERMIT APPLICATION CHECK LIST
th 46GE a-I PLOT V6 ONE Cl 1Z� 2 3 VZr�.� c�, .._ ES N ATE
ZONING 0 APPLICATION
2 . PERMIT I T
3 . OWNER OCCUPANT O
4 . 3 SETS OF S PLAN
5 . NEW CONSTRUCTION
6 . CURB CUT
7 . WATER S
8 . REMODELING
9 . ADDITION
10 . ACCESSORY
11 , SIGN -/--AWNING
1 2 . PERMIT FEE — CHECK ONLY — MONEY ORDER 1-1-- O-q' t�
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER — C R 780
15 . FORM A-
16 , FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs.Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 1 9 Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
n Garage
1. Location Z- `- 2/ vZ` Lot No.
2. Owner's name Josef Address L�S l U�Zy� -I) �C
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? .1��J�rG� �'� d 1e--X157-1,V6; ��� S� ��-
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 cosL-
The undersigned ce ies that the above statements are we to the best of his, her
'2,0 I knowledge and bel J RA
Signature of on ible appicant
Reks
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�S�' iT� �Dxf�J�llT�l�iYlt _
Massachusetts -
DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060 4
HOMEOWNER LICENSE EXEMP'T'ION
--� (Please Print)
DATE: J'
JOB LOCATION:
(M ) (parcel) (Subd' vision)
HOMEOWNER: �,��5if �Gc c 'LE 2 3 �5r0 t2 IJ ,?, ,,)2 ^/01 77M,*7P1-0/l
(Name & Address)
Sul- t/053 5 a`J x,666
(Home Phone) (Work Phone)
The current exemption for "homeowners" was extended to include
Owner-occupied Dwellings of one (1)or two (2) fami 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. 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
BUILDING PERMIT #
' 00 '37
Date Filed - 3�" I File No.
„ - ZONING PERMIT APPLICATION (§1002)
1 Name of Applicant: ,Jo,50111 13e&eG
Address: 7_3 621&57-d,ry 2iv'G Telephone: _yc133
Mo Z nl glyl v lire!
C/2 Owner of Property: . S4/77027
Address : Telephone:
3 . Status of Applicant: Limier Contract Purchaser
Lessee Other (explai.n
4 . Parcel Identification: Zoning Map Sheet# 9,% Parcel#
Zoning District(s) (include o erlys)-
Street Addressa-@
Required
5. Existina Proposed by Zoning
Use of Structure/Property
(if project is only interior work, sksp to #6)
Building height
%B1dg. 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)
.r
7 . Attached Plans: Sketch Plan Site Plan
8 . Certification: I hereby certify that the information cont a ' ed herein
is true and ccurate to the best of my knowl
Date: I Applicant Is Signature: f
,� THIS SECTION FOR OFFICIAL USE O L S
A! roved as resented based on information resented
pp p / p
Denied as presented--Reason:
Sp ial' Permit and/or Site Plan Required:
g Requ' d: Variance Required:
gnatu a Building Inspec 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
m the Board of Hoalth,Conservation Commission, Department of Public Works and other applicable permit granting authorities.
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