35-125 (2) I . ZONING FORM APPLICATION
.Y
2 . PERMIT APPLTQAjjQjj
3 -OC U STATEMENT LIC . # IF NOT
4 . 3 S17-S- S L- T PLAN
5 . NEW CONSTRUCTION
6 . CURB CUT
7 . WATER AVAILABILITY FORMS
8 . REMODELING INTERIOR
9 . ADDITIO
10 . ACCESSORY STRUCTURE
11 . SIGN / AWNING
12 , PERMIT E - 0 y 11 :3 606-
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 v ,•
HOMEOWNER LICENSE EXEMPTION
DATE• �� Ij (Please Print)
JOB LOCATION:
(Map) (1arcel) (Subdivision)
HOMEOWNER: leL, 1 P,O e_ �•, ��.-
(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, 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 Annotated.
HOMEOWNER SIGNATURE
BUILDING PERMIT #
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.. �d Alterations
NORTHAMPTON, MASS. ��/ � / -19-2Z Additions
APPLICATION FOR PERMIT TO ALTER Repair
/ / Garage
1. Location��i (1I`�; Lot No.
2. Owner's name / ,,/l�U/rC� dC�2� Address -,/ e-
3. Builder's name ( Oc ��c. r> /a � Address
Mass.Construction Supervisor's License No. a Expiration Date �7
4. Addition
5. Alteration y
6. New Porch Gk� ����� 16 $i
7. Is existing building to be demolished?
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost:-,W
i
The undersigned certifies that the above �Ytements are true to the best of his, her
knowledge and belief.
nature of responsible app, C
Remarks
0 026 97 Date Filed _ File No.
ZONING PERMIT APPLICATION (§10.2)
1 . Name of Applicant,
Address: /r,_> �_ Telephone:
2 . Owner of Property:
Address: _ - Telephone:
3 . Status of Applicant:Z/Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# arcel# 12 )
Zoning District(s) (include overl s) `51
Street Address2
Required
5 . Existinq Proposed bv Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
— side L,: R: / L: R: o t J
- rear x
• Lot size
Frontage.
Floor Area Ratio
. %Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6 . Narrative Description 9f Pro osed Wo k/Project: (Use additional. sheets
if necessary) r'� .: �P % !�
•Y
7 . Attached Plans: Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
Date: r
� % A,�Z'
- Applicant's�s Signature:
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as presented--Reason:
Special' Permit and/or Site Plan Required:
uir nn R Variance Required:
gnature oaf-$u lding Ins or _.___._____._ r(I _ Da
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply'with all zoning roquiromonts and obtain all required permits
from the Board of Health,Conservation Commission, Departmont of Public Works and othor applicable pormil granting authorities.
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