36-207 (2) �� ,�nn�7 PERMIT APPLICATION LIST
PACE PLOT aU / ZONE Se YES NO DATE
ZONING 1 . F ORM APPLICATION lo
2 . PERMIT APPLICATION �---
3 . OWNER OCCUPANT STATEMENT LTC # IF NO
SETS OF ANS /PLOT PLAN f�
5 . NEW CONSTRUCTION
6 . CURB CUT
7 . WATER V IL ILIT FORMS
S ODELING INTERIOR
9 . ADD ITI `--
0 . ACCESSORY STRUCTURE
SIGN AWNING r�
2 . PERMIT FEE - CHECK ONLY - MONEY ORDER l(oo / qG
13 , SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - C R 780
15 FO EM
16 . FILL
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Deed Ref: Book Z7/-57 Pg. , 316 Plan Ref.: Book 133 _ Pg. 4
NartI761111Pt.all —
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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060 "
HOMEOWNER LICENSE EXEMPTION
DATE: .' / /pz. (Please Print)
JOB LOCATION:
(Map) (Parcel) (subdivision)
HOMEOWNER: /fie IAeylj
(Name & Address)
(Home Phone) (Work Phone )
The current exemption for 11homeowner•s 11 .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 doe[ not nossess a
license, provided that the owner acts as supervisor.' CMR780 Section 109. 1 .1
DEFINITION OF HOMEOWNER: Persons ) 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 SIGNA
BUILDING PERMIT #
b `C> o
C b O r
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. /D/.?-6 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 5' S j r C, N J.-A A. Lot No.
2. Owner's name--12 r�,&P j a P. )4 r j,3lgj j ° Address 5� �3 t C°. J-) i.,la .
3. Builder's name fDEhIN IS f, 1-i F13EY?T Address a c 1-1 L
Mass.Construction Supervisor's License No. Expiration Date
4. Addition 6 / k 13 ' " s S Unr 2 �
5. Alteration —
6. New Porch —
7. Is existing building to be demolished? Ai
8. Repair after the fire &D _
9. Garage xoC`3 No.of cars - Size
10. Method of heating /-4 o-7- 4A2 luTr A 13 A,a F L3 4A ►5
11. Distance to lot lines A2- )c ),F,= ' y0i" 'f'1 i;r Aj t�kr s jpf,' i Q11 JEL i3eLA- Ise), 6?u+.T
12. Type of roof G l.A AS
13. Siding house yFL{DCA L CEDAR.
14. Estimated cost:-
The undersigned certifies that the above statements are true to the best of his, her
kno ge and belief.
Signature of responsible app<<can!
Remarks
Date Filed 0 0 0 42 9 File No.
ZONING PERMIT APPLICATION (510.2)
1. Name of Applicant: DF)VAjjJ /;' &-t 3ZX
Address: ACA , Telephone:
2 . Owner of Property:
Address: 5`'&mze',N I-A Telephone: .
3 . Status of Applicant: -Owner Contract Purchaser
Lessee O her (explain: )
4 . Parcel Identification: Zoning Map Sheet# 3r _ Parcel# X0'7
Zoning District (s) (include overlays)
Street Address
Required
5, Existinq Proposed by Zonin
Use of Structure/Property p ` J-- snn„C
(if project is only interior work, sk p to #6)
Building height
%Bldg.Coverage (Footprint)
Setbacks - front
- side L 'X. R
- rear 310 F
Lot size
Frontage d
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) ALA ON A 61.A-% Suss pf;% y rc',�.,,.a, ,.•,.� Jf�,tie.,.
[]f d i�i F l c.>Aj L j_
7 . Attached Plans: X 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: fp,�26 /V;- Applicant' s Signature;
/ _ THIS SECTION FOR OFFICIAL USE ONLY:
y Approved as presented/based on information presented
De ied as presented
n f Denial:
gnat of Buil Inspector Date
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning requirements and obtain all required permits
from the Board of Health,Conservation Commission,Department of Public Works and other applicable permit granting authorities.
7/92 FXAS
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