25C-009 (2) 'PERMIT APPLICATION CW�CK LIST
PAGE <�-- PLOT 47 ZONE ! � DATE
ZONING FORM APPLICATION
2 . PERMIT I
3 . OWNER OCCUPANT STATEMENT Z LICA IF NO �-'
3 SET PLAN
5 . NEW CONSTRUCTION
6 . CURB CUT
7 WATER
8 . REMODELING
9 , ADDITION
0 . ACCESSORY
11 . SIGN / AWNING
2 . PERMIT FEE - CHECK ONLY - MONEY ORDER .2
13 , SPECIAL PERMIT REQUIRED WITH DEED IF APPLICAB
14 . UNDER SECTION 7 - C R 7
15 . FORM A
16 . FILL
COMMENTS :
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' DEPARTMENT OF BUILDING INSPECTIONS -
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060 , v
HOMEOWNER LICENSE EM4PTION
�-� / (Please Print)
DATE: J( .4
JOB LOCATION• °� --
(Map) _ Va -cel) (Subdivision)
HOMEOWNER:
(Natpe & Address)
�, (Home Phone) (Work Phone)
The current exemption for "homeowners" was extended to include
Owner-occupied Dwellings of one (1 )or two (2) fami 1 ies 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
y 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 SIGNATURE
BUILDING PERMIT # 0 0 _z2�,V-5>
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Zoning 1141—dii K
Miscellaneous Additions Repairs,Alterations etc. Tel.No. "!^ 'E Alterationst - Y
NORTHAMPTON, MASS. --S�*�!• -Z 19 C3 1-/ Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 72� `L: Lot No.
2. Owner's name ',U Address Z 4
3. Builder's name ! Address ,r r
Mass.Construction Supervisor's License No. �..r -'�= Expiration Date
4. Addition
5. Alteration
6. Neiv Porch �.- r ., /&I a
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
t r knowledge and belief.
Signature of responsible app icanl
ks
Remar
X090 .
Date Filed �r �1��.3 i 7 (; . File No.
N �ERMIT APPLICATION (§10, 2)
1 . Name of Applican RC--41C-
Address : .7-7- ' --� Telephone:
2 . Owner of Property:
Address 0 .. Telephone:
3 . Status of Applicant: Vowner Contract Purchaser
Lessee Other (explain : )
4 . Parcel Identification: Zoning Map Sheet# 2-5 G Parcel# ,
Zoning District(s) (include ov 1 ys) CL`
Street Address i ,\ _
5 •
Exist in Pro osed by rr-- n
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%Bldg. Coverage (Footprint)
Setbacks - front
side L: L:
- rear
Lot size
Frontage
Floor nr-- ,G
A—
k/Pro�ect: (Use additional sheets
jv-i yam.;? V 4 i t e Plan
rtfy that the information contained herein
i best of my knowledge.
D, ;antis Signature J
'— FOR OFFICIAL USE ONLY: r ^
n information presented
Lan Required:
Variance Required:
NOTE _�. ,oe 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 olhor applicable permit granting authorities.
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Date Filed .,_j c�(� i � �� '"
O
• r "� File No.
�� , ERMIT APPLICATION
I . Name of Applican :�/ .
Address : Telephone: `�
2 . Owner of Property_ [ f/ � '��� - � i ,, E
Address :-. �Z2Z Telephone: .,
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain : )
4 . Parcel Identification: Zoning Map Sheet# 2_5 L Parcel#
Zoning District(s) (include ov 1 ys) G�7,
Street Address 7EE;x 5G� Required
5 • istin Pro osed b Zonin
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%Bldg. Coverage (Footprint)
Setbacks - front 17f
- side L: L;
- rear
Lot size r
Frontage
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)
v , ,
7 . Attached Plans : tketch Plan Site Plan
8 . Certification: 'Y"I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
Date : j;> Applicant's Signature: �-
THE SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as presented--Reason:
S ecial' Permit and/or Site Plan Required:
nd' g Requ ' d:, Variance Required:
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S gnatur ildin pector �jQ D/iite
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.
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