36-248 (4) Olt
3 C O cDn
o
> -
1= �I
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. r Tel.`No. Alterations
NORTHAMPTON, MASS. C�zI / I iq ' Additions
APPLICATION FOR PERMIT TO ALTER Repair
adrt�+ � ���� Garage
1. Location +�� /A� Lot No.
2. Owner's name *' £{ �1<r?'y1 p t/a �1 i� �+ �' Address l�rT �`✓-% � 't
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished? J
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:-
ri
The undersIg ed certifies that the above statements are true to the best of his, her
knowledge;id belief. %
Signature of responsible app.icant
Remarks
�(it�J r Pr
0
a MAy 1 51996 C�z Irf ort}�a»i ton
i 8 `
litcSdrtc4udcllr
DEPARTMENT OF BUILDrNG INSPECTIONS
INSPGCTOR 212 Main Strcct ' Municipal Building '�V
Northampton, Mass. 01060
HOMEOWNER LICENSE EXEMPTION
DATE: ���Sr (Please Print)
JOB LOCATION:_ 3( 1:2 YS'/ Lib I r(
Map) (Pa c ) ( Subdivision )
1:
HOMEOIN /J /KL
(" ame & Address )
4o l �7
( Hon-e Phone ) (I,iork Phone )
The current exemption for "homeowners" was extended to include
Owner-occupied DwellinQs of one ( 1 )or two (2) fami 1 i es and to allow such .
homeowner to engage an individual for hire who does not uossess a `
license, provided that the owner acts as supervisor . DR780 Section 109. 1 . 1
DEFINITION OF HOi,`?OWN-3R: Person(s ) who own, a parcel o- land on
which he/she resides or intends to reside , on wn- ch there is , or is
J ntended to be , a one or two family dwelling, attached or detached
structures accessory to such use and/or farm structures . 4 person who
constructs more than one home in a two-year JPriod shad not be
considered a homeowner . Such "homeowner" shall summit to the Building
Official , on a form acceptable to the Building 0-fficial , 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 m_ ay be' liable for person(s) you hire to perform work for
i
You under this permit .
The undersigned "homeowner" certifies and assumes responsibility
I for compliance with the State Building Code, City of Northampton
Ordinances, State and Lo al Zoning Laws and State of Massachusetts
x General Laws Annotated AN SHALL BE ON E JO AS SUPERVISOR.
f
� 4 !
i
HOMEOWNER SIGNATTTRE
BUILDING PERMIT (; -
l
f
R ¢ r ..
1
12- 1 t? 7.75.
I / yRW?51 i , -
I I
I
�� f� (All Offn oh� Skufkj
10. Do any signs exist on the property? YES NO L/
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 colt to ba filled in
by the Building Department
r 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:
4vol11me--& location)
13 . Certification: I hereby certify that the information contained herein
�f is true and accurate to the best of my knowledge.
DATE: APPLICANT'S SIGNATURE rM_�rii r %
zonln NOTE: Muu oe of a zoning permit does not relieve an app oanrs b den to oom
pty with all
9 requirements and obtain all required permits from t e Boar of Health, Conservation
Cornmisslon, Department of Publio Works and other applioable permit granting authorities.
:'` FILE #
MAY 1519 ��,�
File No.
wb11TING PERMIT APPLICATION (§10 . 2
PLEASE,L TYPE OR PR1NT ALL INFORMATION
1. Name of Applicant:
Address: &fc:-i Telephone: `)
2. Owner of Property: j� /� /� �r/fir. =� ' ("7i
Address: Telephone: 31Y
3. Status of Applicant: t°Owner Contract Purchaser Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map#— &— Parcel# d'L dr District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property ��� ��c°GL-�LI- �t"'f� C'lV_ ��G!� VA 41,
's zwf
Ji✓
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
C 1� r)
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/Vadance/Finding ever been issued for/on the site?
h
NO DON'T KNOW YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds? � P
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 Cotlservation Commission?
Needs to be obtained Obtained ` ,date issued: _
(FORM CONTINUES ON OTHER SIDE)
FILE # r n n
J
AY 1 51996 ,
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE:
PROPERTY LOCATION:
MAP (� PARCEL: ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERNUT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
lRytilding Permit Filled
el
THE f OLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
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 Conse ation Commissio
9
Signature of Building Inspector Date `
NOTE:issuance of as 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.
CD cn 0 4 AV 0
OP ,yo
LA)
° 0 o v, °D
x
o S • z � Cl)
ao w t9w g .Q n 0
ML
C <
:3 (D n
Q E � O
. °� (D � o
�
UQ � o o SD
0 ° � � O
59 0
CD
LQ
z La
Q)
ot La 00
n
C:i o 0
o
cn
s s
° y
=. 91. :z = = cr
C c� o G7 a• rn
. . r0
CY OC% 0 0
5 5 ao `ro 05. v> nwc
cn O ao as O
A
as co p
CD aq
o x o
oar
�.
sy o �
CD
y
i>
N � O
U l\ p
�I 0`
�—) ] CD
V dF