29-515 (7) of Nort1jampto-a
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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01000 `
HOMEOWNER LICENSE EXEMPTION
W40 (Please Print)
DATE: Lei
JOB LOCATION:
bra /M (Pa/r-, el) (Subdivision)
HOMEOWNER:
(Home Phone) (Flo r�
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 Law , and State of Massachusetts
General Laws Annotated. y
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HOMEOWNER SIGNATURE
BUILDING PERMIT # �,
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. rJ c Alterations
NORTHAMPTON, MASS. /64 9• 19 Additions
Repair
�� APPLICATION FOR PERMIT TO ALTER Garage
1. Location / �lr —Lot No.
2. Owner's name / Address
3. Builder's name ' Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition , A Q
CJAlteration
6. New Porch - Q
7. Is existing building to be demolished? �I.D
8. Repair after the fire �d
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 th ,above statements are true to the best of his, her
owledge and belief.
ignature of responsible app,icant
Remarks
aYCtYx. '
000 -)
r Date Filed d
File No.
ZONING PERMIT APPLICATION (§10 .2)
1 . Name of Applicant: �r
Address : 3 Telephone: s
2 . Owner of Property:
Address : Telephone:
3 . Status of Applicant:_LQtaner Contract Purchaser
Lessee Other (explain: }
4 . Parcel Identification: Zoning Map Sheet#_0 Parcel# - ( ,
Zoning Districts) (include over , ys) _
Street Address
Required
g , Existing Proposed by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%B1dg. Ccverage (Footprint)
Setbacks - front
- side j 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)
Narrative Descriptio of Pr posed Work/Project: (Use add 'tional sheets
if neces ary) v ,
7 . Attached Plans : Sketch Plan Site Plan
8 . Certification: I hereby certify that the information conta ' ed herein
is tru L n accurate to the best of my knowledge.
Date: Applicant ' s Signature�_������_
^THIS SECTION FOR OFFICIAL USE ONLY�J
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Approved as presented/based on information presented
De ied as presented
for ial :
A.
gnat f Bui ing Inspector / Date
NOTE: Issuance of a zoning permit does not relieve an applicants 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.
7/92 FXAS
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PERMIT APPLICATION CHECK LIST
C;�7 PLOT6Z ol
_PAGE 7DT ZON N FO APPL C ON �
2 . PERMIT 6PPLICATION
3 . OWNER OCCUP E E NT. LICj--IE NO
S 0 PL
5 , NEW CONSTRUCTION
6 . CURB CUT
7 . WATER AVAILABIILITY FORMS
8 . REMODELING INTERIOR
9 . ADDITION
10 , ACCESSORY STRUCTURE
11 . SIGN AWNING
12 , PERMIT FE C C )ONLY — MONEY ORDER « u
3 . SPECIAL PERMIT E UIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 — CMR 780
15 FORM
16 , FILL
COMMENTS :