29-340 (12) PERMIT APPLICATION CHECK S �q
YES NO DAfe
2
3 , � p 0
3 SETS OF PLANS /PLOT PLAN
5 . NEW CONSTRUCTION
6 . CURB CUT
7 WATER S
8 , REMODELING
9 . ADDITION
10 . ACCESSORY STRUCTURE
11 . SIGN / AWNING
2 E - MONEY ORDER�
3 . SPECIAL E RMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION - C R 780
15 , FORM A
6 . FILL
COMMENTS:
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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street - Municipal Building
Northampton, Mass. 01060
HOMEOWNER LICENSE EXEMPTION
/ (Please Print)
DATE: Sf 1 b/4s .
JOB LOCATION:
(Map) (parcel) ( Subdivision)
HOMEOWNER: 1it�,?r oh 2vL/ 17,^
(Name & Address)
- SV6 -/S3
(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 L
BUILDING PERMIT #
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
- 0 Garage
1. Location '20 `� ���roo�- - r'v�e.yCC_ Lot No.
wner's name (,19,7,wk Address
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4, Addition _
5. Alteration d
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
13. Siding house
14)stimated cost:-
Z "� The undersigned certifies that the above statements are true to the best of his, her
knowledge ang belief.
Signature of responsible app lcani
Remarks
Date Filed File No.
ZONING PERMIT APPLICATION (910. 2)
0 1 . Name of Applicant: w,7,5 ,
-Telephone:
(2) Owner of Property:. . W,15Qh
Address: toy l4cve��ok �� Telephone:
3 . Status of Applicant: (/Owner Contract Purchaser
Lessee Other (explain )
4 . Parcel Identification: Zoning Map Sheet# � Parcel,# 3�O r
Zoning District(s) (include ov r ays)
Street Address
Required
5 . Existincr Proposed by Zoning
Use of Structure/Property
(if project is only interior wo k, ski 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) — X
Parking Spaces
Loading
Signs
Fill (volume & location)
1
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 contained herein
is true and accurate to the best of my knowledge.
Date: Applicant's Signature:
Y –THIS SECTION FOR OFFICIAL USE ONLY:
Zhpproved as presented/based on information presented
Denied as presented--Reason:
Special' Perm't and/or Site Plan Required:
nd' g Re 'r variance Required:
Sggnatu of Building ctor Date
NOTE: issuanco of a z ng6Cit permit does not repave an applicant's burden to comply witli all zoning requirements and obtain all required permits
from the Board of Hoalth,Conservation Commission, Dopaitment,of Public Works and othor appficablo permit granting authorltios.
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