29-386 (2) PERMIT APPLICATION CHECK LIST
PAGE �1 PLOT ZQNE 13 60 ES NO DATE
1 . ZONING FORM APPLICATION
V
2 , PERMI A-PRUCATION
v
3 .,- - OWNER OCCUPANT E C # IF NO
4 . 3 SETS OF S /PLOT PLAN
5 , NEW CONSTRUCTION
6 , CURB OUT
7 , WATER AVAILABILITY FORMS
8 , REMODELING INTERIOR
9 , ADDITIO
10 , ACCESSORY STRUCTURE
11 , SIGN AWNING
12 , PERMIT FEE - CHECK ONLY - 0 E 0 DER
13 , SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 , UNDER SECTION 127 - CMR 780
15 , FORM A
16 . FILL
COMMENTS :
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Zoning URA
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 584-5575 Alterations WALLS/ CLOSET
NORTHAMPTON, MASS. FEBRUARY 3 , 1995 19 Additions WOOD STOVE
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 36 R R O n K W n O T) D R T V F Lot No.
2. Owner'sname RnrF.R m TnANNF T.()RDFT.T. Address 36 BROOKWnOD DRIVE
3. Builder's name SAME Address SAME
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration wood stove installation remove & change walls 0
6. New Porch
7. Is existing building to be demolished? minor
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating P 1 e c t r i c
11. Distance to lot lines
12. Type of roof t-
13. Siding house ylay7
14. Estimated cosL- $ 18 0 0 . 0 0q /q
The undersigned certifies that the above statements are true to the best of his, her
nknowledge and belief.
Signatur of responsible app,icant
Remarks
t .
Crzf of 'Nart4allyfan
s M _
PIS$fich selfir a
DEPARTMENT OF BUILDING INSPECTIONS _
INSPECTOR 212 Main Street ' Municipal Building '
Northampton, Mass. 01060 "
HOMEOWNER LICENSE EXEMPTION
(Please Print)
DATE: FEBRUARY 3 , 1995
JOB LOCATION: 29/386/001
(Map) (Parcel) (Subdivision)
HOMEOWNER: ROGER &JOANNE LOBDELL 36 BROOKWOOD DRIVE
(Name & Address)
584-5575 586-6950 ext . 293
(Home Phone) (Work Phone)
The current exemption for "homeowners" was extended to include
Owner-occupied Dwellings of one (1 )or two (2) fami 1 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 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 AND SHALL BE ON THE JOB AS SUPERVISOR.
HOMEOWNER SIGNATURE
BUILDING PERMIT #
all .
Date Filed Fphr„arv, 1995. File No.
ZONING PERMIT APPLICATION
1 . Name of Applicant: JOANNE LOBDELL
Address: 36 BROOKWOOD DRIVE Telephone: 584-5575
2 . Owner of Property: c___
Address : - SAME Telephone: SAME
3 . Status of Applicant: x Owner Contract Purchaser
Lessee Other (explain
4 . Parcel. Identification: Zoning Map Sheet# �t� Parcels ,;�,Q_; ,
Zoning District(s) (include verlays)
Street Address ,
Required
5 . Existincl Proposed by Zoning
Use of Structure/Property
(if project is only interio wo kip #6)
Building height
%Bldg . 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) ROMOVE. INSIDE WALL & LOWER ANOTHER WALL TO A HEIGHT OF
• 3 FEET . REMOVE KITCHEN CLOSET AND E'UT7,7 -A CABINET & SHELVING .
INSTALL WOOD STOVE IN LIV.INGROOM. ELECTRICAL CHANGES ARE ITEMIZED ON
ELECTRICAL PERMIT APPLICATION .
7. Attached Plans: NIA Sketch Plan N/A Site Plan
8 . certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowled e.
Date: • .�, 1 /% Applicant's Signature'
�2- �L2
THIS SECTION FOR OFFICIAL S ONLY: r r r _ _ _
(/ Approved as presented/based on information presented
Denied as presented--Reason:
S ecial' Pe and/or Site Plan Required:
i ng R 're variance Required:
gna u of B nspector Da e
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 Cho Board of Haalth, Conservation Commission, Dopartmont of Public Works and otlier applicable permit oranting authorities.
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