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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
HOMEOWNER LICENSE EXEMPTION
(Please Print)
DATE:
JOB LOCATION:
(Map) ()?arcel) (Subdivision)
HOMEOWNER: `L 1t 1- T#')
(N e & Address)
( ,� o i� 1 ✓� X13(�
(Home Phone) (Work hone)
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 at
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 persons) 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 SIGNATURE �
BUILDING PERMIT #
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���j`� Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.Z1 " J 5 /S 3 Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
Garage
1. Location 3 1 L10I V O IS( S+,
Lot No'.t
2. Owner's name`Q SL`1) Yl0 J c.h Slyl rc a:(�i Address 3� A Yek Sf Yvl akn Nffol �Z?
3. Builder's name OLA) I i`C�� Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration CC W?Z1`1 4 'W',A-A C L,t7 3 `� Stdi ✓1�i
6. New Porch
7. Is existing building to be demolished? A 0
8. Repair after the fire ✓1C'
9. Garage no No.of cars Size
10. Method of heating qas
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cosL-
a t!� �, L
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
'".
S gnature of responsible app,icn
Remarks
Date Filed �`l File No.
ONING PERMIT APPLICATION (510. 2)
1. Name of Applicant: S.
>' c k -i- J/i? ;
Address: ; Y
( c,'�kz
Telephone: 5 R s t5 3
2 . Owner of Pro ert _
p Y `
� ✓ l�rn� i;tGj � /Y� r/• � ��r
Address: 3 9� &0 Telephone: YL3'S� S r53 7
3 . Status of Applicant: V/Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheett�C-- ,,�,� w Parcel# ,
Zoning District(s) (include Ul �U�
Street Address 3 "
Required
5 •
Existing Proposed by Zonin
Use of Structure/Property 4—
(if project is only interior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side L: R: L: R:
- rear
Lot size D ,
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 additional sheets
if necessary) 1j e o S;d;,nct ('e D(c2ce�1�v2 � u,� � �,���c, � Po-s�b�e �t?�1 �or2Ut
Y
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: 'Z Applicant's Signature:
T E F A
/ HIS SCTION FOR OFICIL USE ONLY:
1/Approved as presented/based on information presented
Denied as presented--Reason :
S ecial'" Permit and/or Site Plan Required:
'n ng i ed; Variance Required:!5'h
'.
gnat o Build spector Da
NOTE: 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, Department of Public Works and other applicable permit granting authorities.
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