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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No._ Alterations
NORTHAMPTON, MASS. —19— Additions
s
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location ! "_..A,. Lot No.
2. Owners name `°``tw" ddress
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition Yr
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
13. Siding house
14. Estimated cost-
The undersigned certifies that the above statements are true to the best of his, her
knowledge an4elief.
Signature of responsible app icon!
Remarks
'�O�Tttn1.lPTO�
t � �ASf AC(�IldC�ld
DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building '
Northampton, Mass. 01060
1 HOMEOWNER LICENSE EXEMPTION
(Please Print)
DATE; .
JOB LOCATION:_
Nape (parcel) (Subdivision)
HOMEOWNER: r r" ,,A,
(.Na,,a & Addre )
(Hom 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 persons) 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 Annotat AND SHALL BE ON THE JOB AS SUPERVISOR.
HOMEOWNER SIGNATURE
BUILDING PERMIT #
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PERMIT APPLICATION C ECK L ST
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S NO DATE
3 . .,, / L I C. # IF NO
4 , 3 SETS OF PLANS /PLOT PLAN
5 , NEW CONSTRUCTION
6 , CURB CUT
7 , WATER AVAILABILITY FORMS
8 . REMODELING INTERIOR
9 . ADDITION
10 . ACCESSORY STRUCTURE
11 . SIGN / AWNING
12 , PERMIT FEE — CHECK ONLY — MONEY ORQER 21& AiM 7 -5
13 , SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 , UNDER SECTION 127 — CMR 780 --
15 . FORM A
6 . FILL
COMMENTS ; ri a
Date Filed rJ , File No.
ZONING PERMIT APPLICATION (§ . 2)
I . Name of Applicant:
Address:
2 . Owner of Property: .Address : Telephone:
3 . Status of Applicant:AOwner Contract Purchaser
Lessee Other (explain )
4 . Parcel Identification: Zoning Man Sheets � �' Parcel �)-�+'I r
Zoning District(s) (include o , lays)
Street Address d
Required
5. Existin Proposed by Zonin
Use of Structure/Property
(if project is only interior wotk, Vskip #6)
Building height
-Bldg. Coverage (Footprint) I(, .
Setbacks - front
- side L: Y01 R:3, L: 0 R:
- rear A ,�-1
Lot size i - )-T,
Frontacg'e.
Floor Area Ratio
,Open Space (Lot area minus
building and parking) 70 Yo
Parking Spaces
Loading
Signs
Fill (volume & location)
6. Narrative Description of Proposed Work/J? o 'ect: (Use additional fhee,-
if necessary)
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7. Attached Plans: Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained herei
is true and accurate to the best of my knowledge.'
Date: Applicant's Signature:
/ r THIS SECTION FOR OFFICIAL USE ONLY:
_LZApproved as presented/based on information presented
Denied as presented--Reason:
Special- Per 't and/or Site Plan Required:
n 'ng Re ire Variance Required:
gnatur of B n Spector D D e
NOTE: issuanco of a zoning permit does not relieve an applicant's burden to comply with all zoning roquiroments and obtain all required pornam
from tho Board of Hoalth,Consomation Commission, DapaAmord of Public Works and other applicablo permit grantino authoritlos.
MAY 161
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