25C-034 (8) PERMIT APPLICATION CHECK LIST r
PAGE e)5Li PLOT 3 / ZONE '�� `'��" l Z� �'� _� ` ' ES NO DATE
1 . ZONING FORM L C IO
2 . PERMIT I
3 . OW NOT
3 SETS S PLAN
5 . NEWCONSTRUCTION
6 CURB OUT
7 WATER
8 . REMODELING
9 . ADDITION
0 , ACCESSORY STRUCTURE
11 . SIGN / AWNING
2 PERMIT E — C — MONEY O D Z� v�
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABL
4 . UNDER SECTION 127 — C R 780
15 FORM A
6 . FILL
COMMENTS :
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
Garage
Location )L `] -Z b�!-{�l'2/1, 4L)IF— N'6►-i A61 �`� Lot No.
�2 Owner's name S Address_Z 9 AJ O n RJ a'W C, W7'L7�7 r°(DA
3. Builder's name Address_
Mass.Construction Supervisor's License No. _Expiration Date
4. Addition
5) Alteration Re-,X.4) �Ji4T�6-r 14 t+,c SP4c--�- FI),2- Sit)aAc-i`- J 5-1-L)
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:- p 0c)
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
ignature ojresponsible appican!
Remarks
7 B = I
� �ssa�chnartla
DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building '
Northampton, Mass. 01060
HOMEOWNER LICENSE FXEF PTION
(Please Print)
DATE:
JOB LOCATION:
(Map) Parcel) (Subdivision)
HOMEOWNER: C-
(Name & Address)
/ )a-T 6-e-,A_= S �tl 2 S> >-3
(Home Phone) (Work Phone)
The current exemption for "homeowners" was extended to include
Owner-occupied Dwellincls 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/she7
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
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 d.
HOMEOWNER SIGNA
BUILDING PERMIT #
f.
Date Filed 003167 File No.
ZONING PERMIT APPLICATION (510. 2)
1 . Name of Applicant: '� �/}�5 -y
Address : - R N p 2'7+T_2ti li-CE_ T N 0Q ft Telephone: S-yyI z
2 . Owner of Property:_ v�
Address : �" Telephone:
3 . Status of Applicant: r finer Contract Purchaser
Lessee Ot er (explain: )
4 . Parcel Identification: Zoning Map Sheet# Parcel#
Zoning District(s) (include overlqys
Street Address 2 - ag
Required
5 . Existinq Pro Dosed by Zoning
Use of Structure/Property
(if project is only i rior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side L: R.
- rear
Lot size
Frontage
Floor Area Ratio
%Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
signs
Fill (volume & location)
61 Narrative Description of Pr posed Work/Project: (Use additional sheets
if necessary) I '
e Ur�
'r
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: oll� Applicant's Signatui. ,�AL_A
THIS SECTION FOR OFFICIAL USE ONLY:
/-' Approved as presented/based on information presented
Denied as presented--Reason:
ecial' Permit and/or Site Plan Required:
in ing Required: variance Required:
gnat r of Bu ' nspector
..........
.a
NOTE: issu Of n 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 outhoritlos.
%o` L
City of Northampton REQUMD INSPECTIONS
BUILDING DEPARTMENT 2. Footings Walls Components in Place*
3. Complete Building*
No. 1015 Office of the Building Inspector
Zoning Form No. 003167 Date 10/12/94 Fee $40 (heck## 606
Page, 25C parcel 34 ,Zone URB Section 127 ❑ Yes ® No
BUI]LDINGPERMI r-I
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Joel Dansky before Building Inspections
has permission to Renovate attic for storage & study Inspection on Site—Foundations
situated on 29 Northern Ave. Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the terms of the application on file in this office, and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish
of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough
Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection
of this card signed by the Plumbing,Wiring and Building Inspectors.
Building Inspection—Finish
Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE N THE PREMISES
Certificate of Occupancy 7�f -4
Building^I or
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City of Northampton ",QUHW D INSPEMONS
• 1, Footings and walls
BUILDING DEPARTMENT 2. Swronal Components in Plaice*
3. Complete Building*
No. 1015 Office of the Building Inspector
Zoning Form No. 003167 Date 10/12/94 Fee $40 Check# 606
page, 25C parcel 34 ,Zone URB Section 127 a Yes No
B/UILDING PERM I
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Joel Dansky before Building Inspections
has permission to Renovate attic for storage & study Inspection on Site—Foundations
situated on 29 Nortbern Ave. Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the terms of the application on file in this office,and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction,
Maintenance and Inspection of Buildings in the City of Northampton. Inspection of Wiring—Rough z
Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Parish RW /
of this permit.Expires six months from elate of issuance,if not started.
Building Inspection—Rough L'> 1
Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection
of this card signed by the Plumbing,Wiring and Building Inspectors.'
Building Inspection—Parish d4'
Smoke Detectors(Fine Department)
Other
THIS CARD MUST BE DISI IN CONSPICUOUS PLACE QN THE PREMISES
Certificate of Occupancy
Buildin
Gaf'l >'� 11 Sild1