35-054 (7) ERMIT APPLICATION CHECK ST
PAGE � 3 .. � .., ,3N >m ') ES NO
2 . , MI APP r0 ION
3 . I NO
4 . 3 SETS OF PLAN
5 , NEW CONSTRUCTION
6 . CURB CUT
7 , WATER AVAILABILITY S
8 . REMODELING INTERIOR
9 , ADDITION
10 . ACCESSORY STRUCTURE
11 . SIGN AWNING
12 . PERMIT E - MONEY O D P°
13 , SPECIAL PERMIT UI ED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - CMR 780
15 . FORM A
16 , FILL
COMMENTS :
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DEPARTMENT OF BUILDING INSPECTIONS -
1NSPKTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
HOMEOWNER LICENSE EXEMPTION
(Please Print)
DATE:
JOB LOCATION•
(Map) (parcel) (Subdivision)
HOMEOWNER:
(Name & Address)
(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 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 L c 1 Zoning Laws, and State of Massachusetts
General Laws Annotated.
HOMEOWNER SIGNATURE .°
BUILDING PERMIT #
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
:
APPLICATION FOR PERMIT TO ALTER Repair
Garage
Location q57 > 4! Z�j Lot No.
wner s name Address
3. Builder's name 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 S
iding house
se b. E timated cost:-
., The undersigned certifies that the above statements are true to the best of his, her
knowledge�and belief.
Signature of responsible app,ican!
Remarks
i1 J r
Date Filed f 00164 V File No.
ZONING PERMIT APPLICATION (510. 2)
1 . Name of Applicant: k 1j '00k9
Address : Telephone: S-8- CXff
2 . Owner of Property:—Ma s'
Address :- crS kqc, Telephone :
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet#_ Parcel# ")4 ,
Zoning District (s) (include o erlas)
Street Address
Re ired
5. Existing Proposed Zoning
Use of Structure/Property
(if project is only interiob, work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side L: R: 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) r
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 : Applicant' s Signature :
- - - - - - - - - - - - - - - - I - - - - - - - - - - - - - - - - - - - -
THIS SECTION FOR OFFICIAL USE ONLY:
ZApproved as presented/based on information presented
Denied aspresented--Reason:
S cial' Permit and/or Site Plan Required:
ng Re ed: Variance Required:
--Sign a Buildin or Zf a
tA-
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 Hoalth, Conservation Commission, Depaitment of Public Works and other applicable permit granting authorities.
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