32C-195 .PERMIT APPLICATION CHECK LIS
P �` n S NO pATE
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ZONING
2 . AMLICAl
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3 • LICA IF NO
3 SET S PLAN
b . NEW CONSTRUCTION
6 . CURB CU
7 . -WATER S
8 . REMODELING
9 . ADDITION
10 , ACCESSORY U
11 . SIGN / AWNING
2 . PERMIT FEE - CHECK ONLY - MONEY ORDER � L/
13 . -SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 27 - C R 780
15 . FORM A
6 . FILL
CO MENTS •
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DEPARTMENT OF BUILDING INSPECTIONS ?
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060 "
HOMEOWNER LICENSE EXEMP'T'ION
z// / G (Please Print)
DATE; ! / j
JOB LOCATION:
(Map) (parcel) (Subdivision)
HOMEOWNER: _ i/GG/;zzz J, G/z AlJA7 k 122- Ceoss rWrff AW
(Name & Address)
(Home Phone) (Work Phone)
The current exemption for "homeowners" was extended to include
Owner-occupied Dwellings of one (1 )or two (2) fami)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 SIGNA 4/1
BUILDING PERMIT #
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/ Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No `J �7 S Alterations
NORTHAMPTON, MASS. (//zfJ i 9 Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1 Location j ZS &J,G MA1 S 57. Ne R r,#All ejrQ W IV A.OZ40 Lot No.
wnees name kl&4101 Ti !3L/2A/Jfi* Address /22- 0f65_5 /'/9;rP AP.
Builder's name 5 IMJ6 Address 5hme
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration
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
01 . iding house
14. stimated cost- ')�/.61 m o, 110
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
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Signature ofrele ap gicant
Remarks
002891
Date Filed v '7 File No.
ZONING PERMIT APPLICATION (510. 2)
Name of Applicant:
Address: Z Z GOQGSS tP/}T11 F, Telephone: - Z
Owner of Property: J&/G /Z /y//�k
Address:- / ZZ G 0 055 d'%T/¢ fZYJ -Telephone: 5-9-y- $Z 2
Status of Applicant: <f Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# Parcel# lad,
Zoning District(s) (include overlays),. Cvl,G,
Street Address - g ,
Required
5 . Existing Proposed by Zo in
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front �.
- side L: R: L.� R•
- rear
• Lot size l�0 �
Frontage
Floor Area Ratio
. %Open Space (Lot area minus
building and parking) -fJ
Parking Spaces
Loading
Signs
Fill (volume & location)
Narrative Description of Proposed Work/Project: (Use additional sheets
if necessary) C &V 7- &Nf 1111lv0 kl Srr1_19 ry
"1-2 1AIr &6'-
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: -7 Applicant's Signature. J 1 laJ4&eeeld'
� � THIS SECTION FOR OFFICIAL U E ONLY:
!e Approved as presented/based on information presented
Denied as presented--Reason:
Special' Permit and/or Site Plan Required:
Finding Required: Variance Required:_
00,100017
signature of OifildinO Inspector Dat
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply witfi 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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