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DEPARTMENT OF BUILDING INSPECTIONS �
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060 "
HOMEOWNER LICENSE FXFMPTION
_C�
DATE (Please Print)
; c,._.� � 7
JOB LOCATION:- ��J U �J L1 T S ? Cr y C Cp � p 0 1,b,6 J
(Map) ( rc ` ) (Subdivision)
HOMEOWNER:
Tar & 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 Local Zoning Laws, and State of Massachusetts
General Laws Annotated. '
/r'
HOMEOWNER SIGNATURE
BUILDING PERMIT #
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. ��� -5 ' Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Q Garage
1. Location U,L_ _! / l� fC1 �P MCP a�U Loot No.
2. Owner's name torb e /, 19 � I Y!dz-")J Address ����U Jars T r
3. Builder's name cS-L,� Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration /0 jU [ ,,C Q (iX 1-5-7� Axe Ik /UD C ka A17,1-e /A) f Z�.--
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:- S jaba
The undersigned,certifies that the above statements are true to the best of his, her
knowledge �b'elief.
r
ignaiure of responsible app icanl
Remarks
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