35-242 (4) PI=fRIAIT APPLICATION CHECK LIST
PAGE EK PLOT -�L4(� ZONE �� ES NO DATE_
ZONI NQ FORM APPLICATION t--"
2 , PERMIT APPLICATION
3 OWNER OCCUPANT STATEMENT / LIC 1t I( NOT _
3 SETS OF PLANS /PLOT PLAN
5 . NEW CONSTRUCTION
6 CURB CUT
7 WA TEF AVAILABILITY FORMS
8 REMODELING INTERIOR
9 ADDITION
10 ACCESSORY STRUCTURE
11 , SIG AWNING
2 . PERMIT FEE - CHECK ONLY - MONEY ORDER
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - CMR 78.0
15 . FORM A
16 FILL
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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01000
HOMEOWNER LICENSE EXEMPTION
3 (Please Print)
DATE•
JOB LOCATION:
(Map) (Parcel) / ( Subdivision)
HOMEOWNER: U C { s r'- 6
& Address) _
l i (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, 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 C. J C.
BUILDING PERMIT #
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BETTER BUILT SHEDS ,V-'
BUILT ON SITE
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SIZES & PRICES : ON COMPLETE BUILDING
6x6 $635 10x10 $ 995
6x8 $730 10x12 $ 1,125
6x10 $795 10x14 $ 1,255
6x12 $910 1 0x1 8 $ 1,675
ADD MA. SALES TAX
8x8 $ 795 12x12 $ 1,255
8x10 $ 910 12x14 $ 1,485
8x12 $ 995 12x16 $ 1,675
8x14 $ 1,125 12x20 $ 2,350
NOT RESPONSIBLE FOR BUILDING PERMITS
PRICES AND SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
a NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
t l Garage
1. Location 3 5 1 "�� L Lot No.
2. Owner's name c. , Address S Q�'►�-
3. Builder's name '` Address `
Mass.Construction Supervisor's License No. Expiration Date
Addition 1Z, X
5. Alteration
6. New Porch
7. Is existing building to be demolished? 11 0
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:- �p S
6
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
4/ Signature of responsible app,ican!
Remarks
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Date Filed (p q-3 File No.
ZONING PERMIT APPLICATION (510 . 2 )
1 . Name of Applicant: S okl q (-4 vi
Address : 3 _>� Telephone : Z 3
2 , owner of Property: S x �
Address : Telephone :
3 . Status of Applicant : tiOwner Contract Purchaser
Lessee other (explain : )
4 . Parcel Identification : Zoning Map Sheet# Parcel#
Zoning District (s) (include o >rrlays)
Street Address
Required
5. Existincr i Proposed _�by Zoning
Use of Structure/Property if" ^--y�--
(if project is only interior wor)Vr ip to #6 )
Building height
-Ipldg. Coverage (Footprint)
Setbacks - front I
- side L: R: L: 111 D +' R: I t ,- 01
-'rear t
LLot—size Oil t
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 : (Use additional sheets
if necessary)
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 nowledge .
Date : Applicant' s Signatur
THIS SECTION FOR OFFICIAL USE ONLY: r
Approved as presented/based on information presented
Denied as`presented--Reason :
Special' Permit and/or Site Plan Required :
i ding e uired: _ Variance Required :
gnatu e of B ectorp`� at
NOTE: issuance of a zoning permit dons not relieve an applicant's burden to comply with all zoning requirements and obtain all required permits
from tho Board of Health, Consorvalion Commission, Dopmlrnont of Public Works and other applicablo permit granling nuthorillos.
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