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DEPARTMENT OF BUILDrNG INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060 "
HOMEOWNER LICENSE EXEMPTION
(Please Print)
DATE:
JOB LOCATION: ! y *O 427// 5
(Map) (Parcel) (Subdivision)
HOMEOWNER: PC G P 6 7 S C K
(Name & Add ess)
«� Rug (f-t- s7 N el P LE k s -1-7,:
(Home Phone) (Work Phone)
The current exemption for "homeowners" was extended to include
Owner-occupied Dwellings of one (1 )or two (2) fami I ies and to allow such .
homeowner to engage an individual for hire who does not possess at
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 m_ ay 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 Annotated AND SHALL BE ON THE JOB AS SUPERVISOR.
HOMEOWNER SIGNATURE__
BUILDING PERMIT # "
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location / 9 y I�VQ A2 7`y s T_ Lot No.
2. Owners name ,J 12r- >(3 G 1';1,47[iS E-Ae Address r3 a R y 1:9 4Gc. S7-- y
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? S
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 cosL-
�' v�►K h S tab The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible app,icani
Remarks
003357 lj/)
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Date Filed r File No.
ZONING PERMIT APPLICATION
1 . Name of Applicant: [& na G fli `�iS FK
Address :_ 3z vsSf Telephone:
2 . owner of Property: . yy'(
Address : Telephone:
3 . Status of Applicant: owner Contract Purchaser
Lessee Other (explain )
4 . Parcel Identification: Zoning Map Sheet# Parcel# _,D/ ,
Zoning District(s) (include 'overlays)
Street Address
Required
5. Existing Proposed by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side L: R: L: R:
- rear
Lot size
Frontage.
Floor Area Ratio
oopen Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6 . Narrative Description ol Proposed Work/Project: Use additional sheets
if necessary)--0 tj€ 4+ S hf,C-p
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7 . Attached Plans: 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: Applicant's Signature: =i�1 (ter, ga ,1
/ THIS SECTION FOR OFFICIAL USE ONLY:
!�Approved as presented/based on information presented
Denied as presented--Reason:
S cial*' Permit d/or Site Plan Required:
nd g R i ed• Variance Required:
tl_gnatTr-e, 61 Build" D
NOTE: lssuanco of a zoning permit does not relieve an applicanCs burden to comply Willi all zoning roquiroments and obtain all required permits
from the Board of Health,Conservation Commission,Dopartmont of Public Works and other applicable permit oranting authorities.
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