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DEPARTMENT OF BUILDING INSPECTIONS -
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
HOMEOWNER LICENSE RXt?11PrION
(Please Print)
DATE• -
JOB LOCATION:
(Map) (-P -1) (Subdivision)
HOMEOWNER: /-f#,r1)57Yv - -'1,5 15'1- f ,r _E j�d7L
(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 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 Zoning Laws, and State of Massachusetts
General Laws Annota 4ed.HOMEOWNER S I GNA t
BUILDING PERMIT !#
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
a NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
I Garage
Location 0 405-17A.) d f&�F FZ 0 OWC f /Y h 01046 0 Lot No.
J- Owner's name q0 Address_43 P�L/gS Sf J'GV
3. Builder's name Imo' Address
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 °
13. Siding house
14. Estimated cost:_
The undersigned ce ifies that the above statements are true to the best of his, her L� knowledge and b Ief.
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Signature of responsible app,icant
Remarks
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Date Filed File No. 001 v ( .J
ZONING PERMIT APPLICATION (§10 . 2)
1 . Name of Applicant:
Address : v e _ 114 Telephone: 5f, -_4-203
ororad
2 . Owner of Property:_ E H IVS Ka
Address ; lf3 �,41F1 'S St F l-cr /- Telephone :
3 . Status of Applicant: ', Owner Contract Purchaser
,/ Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet// arcel# _
Zoning District (s) (include overlays•'
Street Address r
Required
5. Existing Proposed by Zoning
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
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)
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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 know edg .
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Date: '7/ Applicant's Signattt�
THIS SECTION FOR OFFICIA USE ONLY:
Approved as presented/based on information presented
Denied as presented--Reason:
a'4qlred:t and/or Site Plan Required:
Variance Required :
c�in nspector IYate
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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