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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. � �' Alterations
1 NORTHAMPTON, MASS. f `9"3 9 Additions /
Repair �✓
APPLICATION FOR PERMIT TO ALTER
Garage
1. Location �'� E k nd Fjo� C AAasS Lot No.c2�-41yy 40v1 40
2. Owner's name vie-no, A jci.tl ' 6d, 6',Y Address 6-% 01,nr4 `- c( Flo Vence-
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition ll
5. Alteration ���Q+i� xi S7���C° W
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 >1 14L
13. Siding house
14. Estimated cost:-
-9;Es v
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible app,icant
Remarks
3 e (rzf� of N rtilampfon
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DEPIRTMENT OP BUILOFNC INSPECTIONS
INSPECTOR 212 Main Strcct ' Municipal Building
Northampton, Macs, 01060
HOHEOWNER LICENSE EXEMPTION
ry /� / ( Please Print)
bw w�DATE; 7' / (a
JOB LOCATION : --WY °.<L� ,�e12,d/���o
( M p) ( arcel ) ( Subdivision )
HOML?OW, 2: �t'i t Oct 70 6u ►-V'i~3 O-C} Ell 1O-C f'D't
(Name j & Address )
I_c� ASS . .01640
C3 apt
( Horne Phone ) (wor}, Phone )
The current exempclon for "homeowners" was extended co include
Owner—occupied Dwellir_Gs o= one ( 1 )or two (2) fami 1 ies and to allow such -
homeowner to engage an individual for hire who toes nor possess a
license , provided chat the owner acts as
r !'0_ . C,l1R780 Section 509 . } . }
DE?FINITION OF RUIf?OWNER: Person ( s ) who ow!n a parcel or land on
which he/she resides or intends to reside , on ' 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 riot be
considered a homeowner Such ''homeowner" shall su-bmi t to the Building
Official , on a form acceptable to the Building 0_ fcial , chat he/she
shall be responsible for all such work performer under the building
perm)-t .
As acting Construction Supervisor Y012- press:^Ce on the job site
will be required Lro;,-, time to time , during and uoor• complexion of the
work for which this permit is issued .
Also be advised that with reference to Chapter 1S2 (workers '
Compensation ) and Chapter 1S3 ( Liability of Employers to Employees for
injuries not resulting in Death) of the Massachusetts General Laws
Annotated, you may liable for person( s ) you hire to perform work for
You under this permit .
The undersigned "homeowner" certifies and assumes responsibility
I for compliance with the State Building Code , City of Northampton
Ordinances State and Local Zoning Laws and' State of Massachusetts
General Laws Annotated NO SHALL BE ON THE JOB AS SUPERVISOR.
q
HOMEOWNER SIGNATURE �• �r:O
l
BUILDING PERMIT
10. Do any signs exist on the property? YES NO—
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO�
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
.LACK OF XN.FORMATION.
This column to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks fmnt
- side L• R: L: R:
rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
-Parking Spaces
of Loading Docks
Fill:
:(vo1-1ime--& location)
'13 . Certification: I hereby certify that the information 'contained herein,
Is true and accurate to the best of my know edge
D20E: APPLICANT's SIGNATURE , KG CEO' a
l r, NOTE: lanuanoa of at zoning permit does not relieve an appiloanVe burden to comply-M tl�t;� 1 ~sti?
zoning requirements and obtain all required permits from the Board of Health.; Conservation.,�:
Commisslon, Department of Pubiio Works and other applicable permit granting authorjtl";= ,
Lei;., FILE
tl;;T.
w'
File No. i 1�,9 I
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: /Cc n
Address: -�d Telephone:
2. Owner of Property: > e o ca-. 0 I
Address: Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: �L� 0��{ �
Parcel Id: Zoning Map# Parcel# "! District(s):
(T B .D IN BY THE BUILDING DEPARTME T)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special PermitA/ahance/Finding ever been issued for/on the site?
NO DON'T KNOW X' YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook,body of water or wetlands? NO—)L DON'T KNOW YES
IF YES,has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained ,date issued: _
(FORM CONTINUES ON OTHER SIDE)
FILE # �• i \`7U/+
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE: 5V �
PROPERTY LOCATION:
MA
P PARCEL: ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
70XINC�FORM LED OITT
Foe Paid
iguilding Permit Filled nyt
Fpt-Paid .<
of Plany /Plat Plan
C,
r
THE OLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
Approved as presented/based on information presented
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under:§ w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
Permit from Conservatio ommis io
Signature of Building Ins for Date
NOTE:issuanoa of a zoning permit does not relieve an applicant's burden to oompiy with all
zoning requirements and obtain ail required permits from the Board of Health, Conservation
Commisslon, Department of Public Works and other applioable permit granting authorities.
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