35-190 .PERMIT AEPLICATION CHECK LIS
P A G S NO DATE
Jim1
2
3 . LICA IF NOT
4 . 3 SETS OF S PLAN
5 , NEW CONSTRUCTION
6 . CUBB CUT-
7 , WATER
8 , R ODELING
9 . ADDITION
10 , ACCESSORY
11 , SIGN AWNING
2 , PERMIT FEE - CHECK ONLY -
13 , SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 , UNDER SECTION - CMR 780
15 , FORM
16 , FILL
COMMENTS :-
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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building '
Northampton, Mass. 01060 "
HOMEOWNER LICENSE EXEMP`rION
� �,���_ �� (Pease Print)
DATE: G��
JOB LOCATION:
n (Map) (parcel) (Si�bdivis ' on) I
HOMEOWNER:_ �� G�, .l i,� � �)� 1�'� Pal
(Na e & 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 persons) 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 AND SHALL BE ON THE JOB AS SUPERVISOR.
HOMEOWNER SIGNATURE '
BUILDING PERMIT #
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. / Tel.No.5 Alterations
NORTHAMPTON, MASS.J�_`Q Z'L 19-Ct�i Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 1,"y -p s } i �,� � j; E'Vl[ti' �l/�&1 c 1 YLi Lot No.
2. Owner's name �,IA�,k U& Address —1p VA t,
3. Builder's name Srn VA e Address k
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration
6. New Porch -be L\N l �f{
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
b14stimated iding house
cost:- �
The undersigned certifies that the above statements are true to the best of his, her
(� knowledge and belief.
Qg"Aaiure of responsible appicane
Remarks -
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004035
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Date Filed File No.
ZONING PERMIT APPLICATION
1 ./ Name of Applicant: r a
Address: 1 6uk'c' G elephone: ILS
2 . Owner of Property:
Address : , Telephone:
3 . Status of Applicant: ' Owner Contract Purchaser
Lessee Other (explain )
4 . Parcel Identification: Zoning Map Sheetf n ) Parcel,# NO
Zoning District(s) (include o erlay i��n
Street Address IMF , ti� F
Required
5 . Existing Proposed by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
7Setbacks ldg. Coverage (Footprint)
- front u
- side
- rear
Lot size �� e
F Trontag'e.
Floor Area Ratio
oOpen 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
PAY r��n " C'utr 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 knowledge. ' f
Date: Cr lair (� Appl icant' s Signature: �1 paw
Applicant' s 'v'
THIS SECTION FOR OFFICIAL USE NLY.
Approved as presented/based on information presented
Denied as presented--Reason:
Special' Permit and/or Site Plan Required:
Finding Required: Variance Required:
3Z�/_X�
Signature of 41kilding Inspector �.� Date
NOTE: Issuance of a zoning permit does not rellove an applicant's burden to comply whit all zoning roquiraments and obtain all required pormits
((am tho Board of Hoalth,conservation commission, Dopattmonl of Public Works and other applicable permit granting avthoddas.
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