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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. ' Alterations
NORTHAMPTON, MASS. � �` %a'E� 19 � Additions
APPLICATION FOR PERMIT TO ALTER Repair
? � fr Garage
1. Location
Lot No.
2. Owner's name1 Address
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration
6. New Porch 7
7. Is existing building to be demolished?
8. Repair after the fire
9. Garage ����� No.of cars �+/ Size X1W
10. Method of heating
11. Distance to lot lines 4
12. Type of roof
13. Siding house
14. Estimated cost:-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and r* .//,,
Signature of responsible appicant
Remarks
r�O �OyB
Crif� of Nart4allyptan
s '
« �{asaacf�uatic -
DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building 'w
Northampton, Mass. 01060
HOMEOWNER LICENSE EXEMPTION
(Please Print)
DATE:
JOB LOCATION: 3
(M ) parcel) (Subdivision)
HOMEOWNER:
(Name & Address
� 'L{'/4(cpt. !rlr' �CIGL< c�f/l C1 G' C)
��//,,( H m Phone r) (Work/Phhione )
f2r�
The current exemption for "homeowners" was' extended to include ��� r 7?-
Owner-occupied Dwellings of one ( 1 )or two (2) families and to allow such . K,
homeowner to engage an individual for hire who does not possess a
license, provided that the owner acts as supervisor . CMR780 Section 509. 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 Loc Zoning Laws, and State of Massachusetts
General Laws Annotated AND SHAL N THE JOB AS SUPERVISOR.
HOMEOWNER S I GNATURE '
BUILDING PERMIT 411
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 col- to be filled in
by the Building Dapzrtment
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# pf -Parking spaces
of Loading Docks
Fill:
' (Vol-time--& location)
13 . Certification: I hereby certify that the information contained herein
r, . is true ands accurate to the best of my knowledge. .
�
DATE: � -t' APPLICANT's SIGNATURE
NOTE: Issuanoe of at zoning permit does not relieve an- pp ijo nrn burden to comply with all
zoning requirements and obtain all required permits from he Board of Health. Conservation
Commisslon, Department of Publio Works and other nppli able permit granting authorities.
FILE #
C
k
LJ
P P
OCT 2 0
1,
. .
DEBT CF;3JILEt�f�G A"SW ��0AS
t1kTilAfat MCI
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: e�4 vl. a t,V"c�,j
Address: 4 57 Telephone: Yf?>
2. Owner of Property:_ /c�p(� �_) �c�c�,��s 1'-j
Address: pct c� C'- Telephone: C CA
3. Status of Applicant: ,c Owner Contract Purchaser Lessee
Other(explain):
4. Street Address: , ��{ �2�c=cCc >ctf^(r
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property �` ilt` Z ice a, r L
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets i necessary)-
a
-7r`�
- ✓ j/ �( --C � � S� �' r yam;
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 Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW 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 Document#
9. Does the site contain a brook, body of water or wetlands? NO 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 # )
APPLICANT/CONTACT PERSON: �L Mz,_X-
ADDRESS/PHONE:
PROPERTY LOCATION: p �1E �� lG
MAP �IS6;1 PARCEL: ;,�3 3 ZONE
THIS SECTION FOR-:OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOS D REQUIRED DATE
ZONING FORM MLED 0111
Fee Pnid
'Building Permit Filled mit
Plan^s /Plot Plan
c> S
/� G`
THE_LLOWING 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
I/
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 nservation Co Sion
d L
Signature of Building hist Date
NOTE:issuance of a zoning permit does not relieve an applioant's burden to oomply with all
zoning requirements and obt ain a it
all required perms from the Board of Health, Conservation
Commission, Department of Pubiio Works and other applioable permit granting nuthortties.
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