29-237 (5) PERMIT APPLICATION CHECK LIST
YES NO DA Iti
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2 y
3 LI .# IF NOT
4 . 3 SETS OF PLANS PLAN
5 . NEW CONSTRUCTION
6 . CURB CU
7 . WATER AVAILABILITY FORMS
8 . REMODELING INTERIOR
9 . ADDITIO
10 . ACCESSORY- STRUCTURE
1 . SIG AWNING
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12 . PERMIT FEE ONLY - MONEY ORD R #'
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - CMR 780
15 . FORM
16 . FILL
COMMENTS :
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DEPARTMENT OF BUILDING INSPECTIONS =
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060 y ,
HOMEOWNER LICENSE EXEMPTION
(Please Print)
DATE: 1z- /�_
JOB LOCATION: 2-9 dzi 5
(Map) ()?arcel) (Subdivision)
HOMEOWNER: �/ WIVA- J CarZs f it-t he d/y d,
n Name- & Address) /
v
(Home Phone) (Work Phone)
The current exemption for "homeowners" was extended to include
Owner-occupied Dwellings of one (1 )or two (2) fami lies 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, oft 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 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 AnnotaZe .
HOMEOWNER SIGNATURE `
BUILDING PERMIT #
-NOTE-
" THIS PLAT IS COMPILED FROM DEEDS, PLANS AND OTHER
SOURCES AND 1S NOT TO BE CONSTRUED AS AN ACCURATE
SURVEY AND IS NOT TO BE RECORDED.
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TO: STATEWIDE FUNDING CORPORATION &
COMMONWEALTH LAND TITLE INSURANCE COMPANY
1 HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES AND BASED ON EXISTING
MONUMENTATION ALL EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON
THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES,
EXCEPT AS NOTED. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED WITHIN
A FLOOD PRONE AREA AS SHOWN ON FEDERAL FLOOD INSURANCE MAPS FOR
COMMUNITY # 2 5 016 7
Q�^� �' -1-� GAGE L
SURVEYOR:
THIS PLAT FOR MORTGAGE LOAN PURPOSES ONLY
AND DOES NOT CONSTITUTE A PROPERTY SURVEY
of -MORTGAGE LOAN INSPECTION PLAT-
r w1NDALL NORTHAMPTON, MASSACHUSETTS
PREPARED FOR
# 32 DANA J. GEIS & KIMBERLY A. PALMER
oF�s ► � SCALE: 1 "=30 ' JANUARY 22 , 1994
�gxe$0 HAROLD L. EATON AND ASSOCIATES, INC.
REGISTERED PROFESSIONAL LAND.SURVEYORS
235 RUSSELL STREET - HADLEY - MASSACHUSETTS
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS.e I 19 Additions
a Repair
APPLICATION FOR PERMIT TO ALTER Garage
1. & ��-CXJIL7 ^LL //�-;`- �y Lot No.
2. Owner's name ./,) /� J l7�5 �!/jZ�JC y A• �A/A41Address Z1 Albwll C7 F16&WW-
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration r5; 5
6. New Porch
7. Is existing building to be demolished? A/D
8. Repair after the fire
9. Garage .&412A C-0 No.of cars Size
10. Method of heating --�c C '3 4
11. Distance to lot lines F7,
12. Type of roof
13. Siding house
14. Estimated cosL- ��
��)q The undersigned certifies that the above statements are true to the best of his, her
knowle a and belief
Signature of responsible appicant
Remarks lit/i Ce�Gu ` S��/"� A-4
i •
001?390
Date Filed File No.
ZONING PERMIT APPLICATION
(§10. 2)
1. Name of Applicant: /
Address:Z/ 1-7 ylai r1/l - MA -- Telephone:
2 . Owner of Proper ty: +J 4-7s
Address 2/ ,""d e7 fli2�itC'c� 14__ 7 Telephone: ,5-J%- 716P----
3 . Status of Applicant: caner Contract Purchaser
Lessee Other (explain )
4 . Parcel Identification: Zoning Map Sheet# Parcel# D
Zoning District(s) (include overlays)
Street Address
Required
5• Existing Proposed bv Zoning
Use of Structure/Property roc-n+7 l SA^4r-r
(if project is only interior work, skip to #6)
Building height
%B1dg.Coverage (Footprint)
Setbacks - front
- side L: R: s6 L: R:
- rear -5-0- -> r,,
Lot size i cs SRS,.
Frontage. 5 s,�,,,,
Floor Area Ratio iZ p
. %Open Space (Lot area minus
building and parking) 9 3S-b
Parking Spaces a
Loading
Signs — —
Fill (volume & location)
6. Narrative Description of Proposed Work/Project: (Use additional sheets
if necessary) r6&Nrlc _ U�
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 knowln
Date:., - /Z - Applicant I s Signature: ��
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as presented--Reason:
Special' Permit ,and/or Site Plan Required:
wed
F di g Requ ' : variance Require
S gnatur, uilding ctor Da e
g
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply wilh 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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