25C-038 (3) PERMIT APPLICATION CHECK LIST
PAGE . . tQT -5S 1E '" o , YES NO DATE
ZONING FORM APPLICATION
2 . PERMIT APPLICATION
3 4 OWN __--�--.-PI�IC. #'IF NO
4 . 3 SETS OF S PLAN
5 . NEW CONSTRUCTION
6 . CURB CU
7 . WATER AVAILABILITY S
8 . REMODELING IN
9 . ADDITION
10 . ACCESSORY STRUCTURE
11 . SIGN AWNING
2 . PERMIT FE - O - MONEY ORDER
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - CMR 780
15 . FORM
16 , FILL
COMMENTS :
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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street 4 Municipal Building '
Northampton, Mass. 01060 "
HOMEOWNER LICENSE EXEMPTION
DATE; oa 9e (Please Print)
JOB LOCATION:_ C
( ap) (far el) (Subdivision)
HOMEOWNER: GeS/I St&,eGJ ;, Ma`fiC ���I��P
(Name & 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
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 #
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. f3y�1 ao� 19�y Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location U14 Nord Lot No.
2. Owner's name OqA f1�t{� Address l IVC-Pt ep-A) aA
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration j)1uM6i!4Q TetTt try
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 and belief.
jSignature of responsible appicant
Remarks
: 003 .88
Date Filed File No.
ZONING PERMIT APPLICATION (510 . 2)
1 Name of Applicant: ku-)
Address : �, Telephone:
2. Owner of Property: ,,/, majl.r HA lek
Address : j/ A ,, ) Telephone :
Status of Applicant: owner Contract Purchaser
• Lessee Other (explain:
4 . Parcel Identification: Zoning Map Sheet#-.2�G Parcel#3,
Zoning District(s) (includeA overlays)
Street Address ll�t k� ,
Required
5. Existinq Proposed, by Zoning
Use of Structure/Property
(if project is only interior wo , skip to
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side L: R: L: R:
- rear
Lot size &COD K 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/Pro 'ect : (Use additional sheets
if necessary)
01p,nc c. ti%� c�'k Q)Grs t>\ W
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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.
te: il-ldylw Applicant's Signatur
ZApproved THIS SECTION FOR OFFICIAL USE ONLY:
as presented/based on information presented
Denied as presented--Reason :
S cial Perm' and/or Site Plan Required:
' ng Req e variance Required:
gnat of u� ldin - Da e
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning roquiroments and obtain all required permits
from the Board of Health, Conservation Commission, Department of Public Works and other applicable porrr)il granting authorities.
%e?I)-
City of Northampton REQUIRED INSPECTIONS
BUILDING DEPARTMENT 1. Footings and s
2. Structural Components in Place*
3. Complete Building*
No. 850 Office of the Building Inspector
Zoning Form No 003188 Date 8/29/94 Fee 40 Check# 1274
Page, 25C Parcel 38 ,Zone URB Section 127 ❑ Yes ® No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTHUS THAT Matthew Haller before Building Inspections
has permission to Renovate 2nd floor kitchen & bathroom. Remove closet. Inspection on Site-Foundations
situated on 9-11 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 CONSPICU PL PREMISES
Certificate of Occupancy i -
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lilt of Northampton REQUIRED INSPECTIONS
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1. Footings and Walls
BUILDING DEPARTMENT
�► � 2. Structural Components in Place*
3. Complete Building*
No. 850 Office of the Building Inspector
Zoning Form No. 003188 Date 8/29/94 Fee 40 Check# 1274
Page, 25C Parcel 38 ,Zone URB Section 127 L) Yes ® No
BUI]LDING PERT M
*Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Matthew Haller before Building Inspections
has permission to Renovate 2nd floor kitchen & bathroom. Remove closet. Inspection on Site—Foundations
9-11 Northern Ave. Inspection of
situated on � � Plumbing—Rough
g
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. ,Y-
C e 5 we 7
Building Inspection—Finish
Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAX.0 C0NSPICU0LJj9PL CE PREMISES
Certificate of Occupancy
B spector
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