36-170 (4) -TIN
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�`,�PERMIT APPLICATION C E S
PAGE S('o PLOT 170 ZONE W4— 731 C YES NO DATE
ZONING IC IOlg5
2 . PERMIT �^
3 . IF NOT f/
4. 3 SETS OF PLANS /PLOT PLAN
NEW CONSTRUCTION
6 . CURB OUT
WATER 7 .
8 . REMODELING
9 . ADDITION
10 , ACCESSORY
11 . SIGN / AWNING
2 ERMIT FEE - CHECK ONLY - MONEY 0 DER 0-703
13 . SPECIAL PERMIT BEQUIRED ED IF APPLICABL
4 . UNDER SECTION 7 - C R 780
15 , FORM A
16 , FILL
COMMENTS :
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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building '
Northampton, Mass. 01O60 y `,
HOMEOWNER LICENSE EXEMPTION
n� (Please Print)
DATE: �(
JOB LOCATION: / 70
(Ma parcel) (Subdivision)
HOMEOWNER:
�
(11arde & Address) C-
(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 Off icial, 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 AND SHALL BE ON THE JOB AS SUPERVISOR.
HOMEOWNER SIGNATURE
BUILDING PERMIT #
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
/ Garage
1 Location 7 3 9 /--/,o/-e n t? A � GY Lot No.
2 Owner's name�a ���,.c G _ �� rod Address Via-m -cam_
Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
Addition IJ V C �`i(?6A
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
0. Siding house
14. Estimated cost- $ lee
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
JllA tt C° j L-jo�
Signature of es onsible appicant
Remarks
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Date Filed 004083 File No.
ZONING PERMIT APPLICATION (§10. 2)
l
Name of Applicant: c
Address:. ,?) = - -Telephone: /
2 Owner of Property: p ror'd
Address : `7` `b & • Telephone:
3 ,, Status of Applicant:Zwner Contract Purchaser
Lessee Other (explain )
4 . Parcel Identification: Zoning Map Sheet# Parcel# 070 ,
zoning District(s) (inclu ays)
Street Address ' 3 ,
Required
5 . Existincf Proposed by Zoning
Use of Structure/Property
(if project is only` interior wotk,V ski to #6)
Building height
g. Coverage (Footprint)
Setbacks - front l
- side L: JD1 R: % L: b ` R: 3 r
- rear q0 Q
- e All i7 t1"D'll
Frontage.
Floor Area Ratio
.Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (vol ume & location)
Narrative Description of roposed work/Project: _ (Use additional sheets
if necessary)
6 .
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: Applicants Signatur .-
r THIS SECTION FOR OFFICIAL USE NLY
pproved as presented/based on information presented
Denied as presented--Reason:
Special* Permit and/or ite Plan Required:
Finding Required: Variance Required:_
S. gnature of uil 1 g Inspector Dat
NOTE: issuance of a zoning permit does not relieve an applicant's burden to comply wigs all zoning requirements and obtain all required pormfts
from the Board of Health, conservation commission, Dopattmant of Public Works and otlicr applicable permit granting avthoritSos.
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