29-295 (2) PERMIT APPLICATION CHECK S
w,
PA GE PLOT 02� ZONE �� _ S
NO DATE
ZONING FORM LIC IO
2 . PERMIT I
3 . OW O L/
NEW S
6 CURB CUT
7 WATER
8 . REMODELING
9 , ADDI I
0 , ACCESSORY
11 . SIG ,,tt �
2 E R - - �`
3 . SPEC IAL PERMI-T--REQUIRED WITH pEEp IF APPLICABLE
4 , UNDER SE - QMR 780
15 . FORM A
6 . FILL
COMMENTS :
�st+�xpr
�o oy
�RSSRC(�Udf�(d _
DEPARTMENT OF BUILDING INSPECTIONS -
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
HOMEOWNER LICENSE EXEMPTION
(Please Print)
DATE;
G �
JOB LOCATION:
(Map) (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 '
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 ' AND SHALL BE ON THE JOB AS SUPERVISOR.
HOMEOWNER SIGNATURE
BUILDING PERMIT #
> O
c
a
Z
>
�; "► rn
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
ti NORTHAMPTON, MASS. 19 Additions
' APPLICATION FOR PERMIT TO ALTER Repair
7
pew,-1,15174- Garage
ation �LORE/V CE _ /�� Lot No.
r's
2 Owne name ter',7 z2:6Lnq.flj4,C DA,
3. Builder's name � � Address
Mass.Construction Supervisor's License No. Expiration Date
Z&
A
5` Iteration WEln^)t/- ®1D 'K—cam/-' jN/.rlr�.ES °►�P�1;7�"� �VEW `P'9al 6l
6. New Porch
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
Siding house
D 14. stimated cost:-
The undersigned certifies that the above statements are we to the best of his, her
knowledge and belief.
Signature oJresponsible app,icant
Remarks
''
Date Filed File No.
ZONING PERMIT APPLICATION (§10. 2)
1 . Name of Applicant: /L
J Address: �� Telephone: _ f�
2 . Owner of Property:
Address: , Telephone:
3 . Status-`of Applicant: C_—Owner Contract Purchaser
Lessee Other (explain )
4 . Parcel Identification: Zoning Map Sheet# Parcel#,
Zoning District(s) (include _ ov rlays) ..
Street Address ,
Required
5. Existinq Proposed by Zonin
Use of Structure/Property
(if project is only, interior wo skip #6) - `
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side L: R. L:
- rear
Lot size
Fronta4__ .
Floor Area Ratio
• %Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume location) .
66 Narrative Descri tion of Proposed Work/Project: (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 knowle ge.
Date: 3" Applicant Is Signature:
THIS SECTION FOR OFFICIAL USE LY: -
ZApproved as presented/based on information presented
Denied as presented--Reason:
Special' Permit and/or Site Plan Required:
Finding Re ired: Variance Required:
S. gnature of ui ding Inspector �M DatiY
NOTE: issuonoo of a zoning permit does not relleve an applicant's burden to comply tvilh all zoning requirements and obtain a!I required permits
from the Board of Hoafth,conservation Commission, Dopaitmont of Public Works and ottror applicablo permit oranting autfiort4os.
UAM
za
C)
a3 o �
pt
O N O O o ( I I I I bA
w v� U � A w° r, A '� � � 0 r- o �
ON i I K
vn ry Gr
w
N N CA C C S bA s.
o o O °A s V
rZ
Q V)
S S S E v�
ul
z
�
O
o V
o '=
0 �
r A ro �.� o
Oro � o
4mm r-
O o v 4-4
4-3 a
� ro g ro
v Q03 W
3 .c �4
M■`I uE >,.c 0.
, s�a � p
row v
x � r ° o ff ' �3
a
>+ O T�
O >
N 7� O N ,gyp �� a}
cd
ego o prom C!1
.' 'AwU) oo
[s�
r � OIC
au
•ae.y.�� Z N Q, U