32C-202 (4) (IN
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PERMIT APPLICATION
CH`ECK S
PAGE C PLOT z_)_6� ZONE YES NO DATE
1 . ZONING FORM APPLICATION
2 . PERMIT I
3 . OWN # IF NOT
4 . 3 SETS OF S PLAN
NEW CONSTRUCTION
6 . CURB CUT
7 WATER S
8 . REMODELING
9 . ADDITION
10 . ACCESSORY STRUCTURE
1 , SIGN / AWNING
2 ER MIT FEE C - MONEY --ORDER
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABL
14 . UNDER SECTION 127 - C R 780
15 , FORM
16 . FILL
COMMENTS :
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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building '
Northampton, Mass. 01060
HOMEOWNER LICENSE EXEMPTION
Ir� ` (Please Print)
DATE:— /
JOB LOCATION: O P
p) (farce ) (Subdivision)
HOMEOWNER
(Na & Ad ess)
(Home Phone) (Work Phone)
The current exemption for "homeowners" was extended to include
Owner-occupied Dwellings of one (1 )or two (2) fami I 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 Off icial, 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 m_ ay 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 Zo ing Laws, and State of Massachusetts
General Laws Annotated N SP BE ON THE JOB A UPER VISOR.
HOMEOWNER SIGNATURE
BUILDING PERMIT
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No"� 9_, ~ Alterations
NORTHAMPTON, MASS. 19 Additions
• APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location l✓j iA /' ��'� Lot No.
2. Owner's name S �3, 5% f�.. Address ' tom'.11",-VILI s
3. Builder's name ���tvtil _,° Address 1/9 �L:%s„ , t�/”..
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Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration r l � t r � cf -
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire N)U
9. Garage I c^-1 t No.of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof
13. Siding house e)
14. Estimated cost- e>✓'z'
The undersi ned certifies that the above ements are we to the best of his, her
w dge lief. I
Ia 0
Sin a of responsible app icon!
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Remarks
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00346.(
Date Filed File No.
ZONING PERMIT APPLICATION (510.2)
1. Name of Applicant:
Address: LEI-) 5 7- f,,t� o` � Telephone:
2 . Owner of Property: 5 ,e
Address: Telephone:
3 . Status of Applicant: ✓ Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# -32-G Parcel# z�o,�
Zoning District(s) (include//��o er a �J�,) WLb
Street Address 1p � ° ► 5'
Required
5. Existina Proposed by Zoning
Use of Structure/Property jv/�'rt�� ='Si e- 'oems=. ?�
(if project is only interior work, skip to #6)
Building height
%B1dg.Coverage (Footprint)
Setbacks - front
- side
- 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 4dditional sheets
if necessary) r�e�•� L��� �f/'�i - � -'� �c' �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: U A Signature:
- - - - - - - - - - - - - - - -
THIS SECTION FOR OFFICIAL USE ONLY:
(/Approved as presented/based on information presented
Den'ed as presented
so or D dal:
gnatur Buildin ector �� D e
(VOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning requirements and obtain all required Permits-
from the Board of Health,Conservation Commission,Departrnent of Public Works and other applicable permit granting aut-ities.
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