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35-206 (4) HERMIT APPLICATION CHECK LIST 0'\OG ZONE L q V 6tat:l �X -YES NO DATE FORM APPLICATION { Lo 248 IT Aep­OtAllam, C.# IF NOT 3 PLAN 5 . NEW CONSTRUCTION 6 . CURB CUT 7 . WATER I FORMS 8. REMODELING INT 0 9 ADDITION 10 . ACCESSORY 11 , SIGN / AWNING 13 , SPECIAL PERMIT E U ED WITH DEED IF APPLICABLE 14 . UNDER SECTION 127 - CMR 780 15 FO 16 . FILL COMMENTS : 1 of 'Wart4allyttin t Aasaecelltuetta DEPARTMENT OF BUILDING INSPECTIONS � INSPECTOR 212 Main Street ' Municipal Building Northampton, Mass. 01060 " HOMEOWNER LICENSE EXEMPTION DATE- J© G (Please Print) JOB LOCATION:- L)/T� jo t T e&__ ( e-r — (Map) ()?arcel� (Subdivision) HOMEOWNER:— �,N .. -4-U J d-�, ; 6, ti (Name & Address) yW4, aW_76 Z (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 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, 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 Local Zoning Laws, and State of Massachusetts General Laws Annotated. HOMEOWNER SIGNATURE BUILDING PERMIT > > 2 I � � T z a O 1 N :Z • v Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations NORTHAMPTON, MASS. 19 Additions APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location V te'fr �� T '�- F'l t9 Lot No. 2. Owners name I��� Address .�V S m -- 3. Builder's name 611 � ) O l9 Address U Mass.Construction Supervisor's License No. Expiration Date 4. Addition - e (RC i r S7r- 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. Siding house 14. Estimated cost:41 Cl dZ The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. Signature of responsible app scant Remarks Now- 4.ivrn. Date Filed 5 /0 -.1y File No. ZONING PERMIT APPLICATION (910. 2) 1 . Name of Applicant: -TU.4 I k S,\ti Address: L( ,� g-fK to 1"7 ee-L r Telephone • �-p -7 a` 2 . Owner of Property: Address : Telephone : 3 . Status of Applicant: L-6`wner Contract Purchaser Lessee Other (explain. ) 4 . Parcel Identification: Zoning Map Sheet# 35 Parcel# ZO G , Zoning District (s) (include ove lays) .5 Street Address /Z`e`-1 t Required 5. Existinq Proposed by 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: �—JD - 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 : JUse additional sheets if necessary)_ Vt j2,�-" _ -�/ ,� � ��/ LOJALP V , &e-c4e 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: 1,v-ck C�7, / THIS SECTION FOR OFFICIAL US ONLY: Approved as presented/based on information presented Denied as presented--Reason: Special' Perm and/or Site Plan Required: F ' d ' g Req Variance Required: Z _ gnatur f Bu nspector `� a 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 Health, Conservation Commission, Depaitmont of Public Works and other applicable permit granting authorities. i C"f')- is a � — W a , V1 � a3E:� o � A a o' ° o' •° ° a' , w Cn cg w° .S o,u o o a14 NM w o a ° ° Lr Ono CN S S S o � � U � � Z gz OX do y Iola O4-1 y O bA ° GGG CN ON y . H l4 O N p 'd4+ � U+ C w U M Ln O Mr ON*44 m, 01