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35-208 (2) ? _ Z� �� 4 5 : a . .:.:,'. I 46 � � 9 � �cssrtcflusclli - DEPARTMENT OF BUILDFNC INSPECTIONS INSPECTOR 212 Main Street ' Municipal Building Northampton, Mass. 01060 HOMEOWNER LICENSE EXEMPTION (Please Print) DATE; /}ao,- 1 ,17- . 1 9l o/(o JOB LOCATION: "� S (Map) (parcel ) ( Subdivision ) HOMEOWNER: 4, 11015 �. 7-4 �y s3� u,e,-5 (Name & Address ) ( Hon-�e Phone ) (work Phone ) The current exemption for "homeowners" was extended to include Owner-occupied wellings of one ( 1 )or two (2) fami 1 ins and to allow such . homeowner to engage an individual for hire who does not possess a ' license , provided that the owner acts as superviso__ . CNfZ780 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 ch 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 ueriod shall not be considered a homeo�'rner . Such "homeowner" shall submit to the Buildina Official , on a form acceptable to the Building official , that he/she shall be responsible for all such work performed under the buildinq 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 auvised 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 maybe" liable for person(s) you hire to perform work for You under this permit . t 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 (# a w > o T � 7 a M r ,Z.3 ^� I PD Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations 1 NORTHAMPTON, MASS. API /-� 19 Additions APPLICATION FOR PERMIT TO ALTER Repair ,^ Garage 1. Location 3 c G 5 f(-c 'n 0 71e' ,2d : �e,r irr) 0 lerzi fx--cc Lot No. 2. Owner's name -F- A Address art j'� ,tor l�ixrrrPrLtr 3. Builder's name Address Mass.Construction Supervisor's License No. t ? rz Expiration Date 4. Addition 5. Alteration rc. 0"2 ���k( j`d4•i K;F� -.1-- 50 f'i'r s 6. New Porch 7. Is existing building to be demolished? 'y O 8. Repair after the fire A2/tq 9. Garage A''/4 1 No.of cars Size 10. Method of heating / 11. Distance to lot lines 12. Type of roof X14 13. Siding house X4141 1oi-N c-;' ck-) U'r C- 14. Estimated cost:- J 0 chi 0 The undersigned certifies that the above statements are true to the best of his, her knowled and belief. Signature If r sponsible appicani Remarks r � ��rrE cSr)7G' �/G �� �I��CJS✓i/�"L�E� LC502G•,`��? SfG� 7 it�� Ev ek) Y- Zfr t V/ c l �ih" ✓��xc-��r f�c�cz ri - U`Gyi'�; 5���r� � e Y� 10. Do any signs exist on the property/? YES NO ✓ IF YES,describe size,type and location: Are there any proposed changes to or additions of signs intended for the property/? YES NO IF YES,describe size,type and location: 11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. This —7— to be filled in by the Balding Department Required Existing Proposed By Zoning Lot size Frontage Setbacks - frnnt - side L: R: L: R: - rear Building height Bldg Square footage '/60pen Space: (Lot area minus bldg &paved parking) # pf Parking spaces j¢` of Loading Docks Fill: (vol-lime--& location) 13 . Certification: I hereby certify that the information contained herein is tru a d accurate t9 the best of my kno edge. DIffE: - (r -APPLICANT's SIGNATU NOTE: kga a e wit to zoning permit does not relieve-H-FrlipplloanlVs buy-den to mply with all zoning req rem nts and obtain aH required permits from the Board of Healt , Conservation Commission De artment of Publio Works and other applioable permit granting authorities. FILE if 9 996 'lf/(�Y • / File No �) PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: Address: �Qj1A, d . Telephone: 76 2. Owner of Property:_ s Address: Telephone: 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain): f� 4. Job Location: � ,P � � AY Parcel Id: Zoning Map# Parcel# � �1 District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property . 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): 7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files. 8. Has a Special PermiWariance/Finding ever been issued for/on the site? NO DON'T KNOW t--� YES IF YES,date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW YES IF YES: enter Book Page and/or D�oc-°ument# 9. Does the site contain a brook, body of water or wetlands? NO L— - DON'T KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained ,date issued: _ (FORM CONTINUES ON OTHER SIDE) FILE 4 = � APPLICANT/CONTACT PERSON: f ��� ADDRESS/PHONE: PROPERTY LOCATION: MAP - PARCEL:— ZONE THIS SECTION FOR-OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE 7,0XING FORM M.1211 OUT Fee Pa*d "Rnilding Permit Filled ovit f � — of Pinn-s I Plot Plan ✓' TBj5E,F6LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: Approved as presented based on information presented Denied as presented: Special Permit and/or Site Plan Required under: § PLANNING BOARD ZONING BOARD Received&Recorded at Registry of Deeds Proof Enclosed Finding Required under:§ w/ZONING BOARD OF APPEALS Received&Recorded at Registry of Deeds Proof Enclosed Variance Required under: § w/ZONING BOARD OF APPEALS Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval-Bd of Health Well Water Potability-Bd Health Permit from onservat' mmissio Signature of Building ector 16ate NOTE:lssuanoe of a zoning permit does not relieve en applioanYs burden to oompty with all zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Publio Works and other applioable permit granting authorities. z *� °* a O ' Co o Ul 0 En CL z 0 ° ° CD S o 10 ri N 00 �..D +00 N CD x � C �• C�D Ct. � CJ' D � � b ro � ° aCD � fD ° ° c, rt Oq � y S rt O � y ate . o pLO cn cn ., ... 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