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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
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1. Location n t c� Lot No.
2. Owner's name '"`t Address 'J � { I �l
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration A C-1- e C c.< C)
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 an belief.,
Signature of esponsible app icanr
Remarks
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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building '
Northampton, Mass. 01060 ' v
HOMEOWNER LICENSE EXEMP`T'ION
(Please Print)
DATE: - -
JOB LOCATION:
(M ) ( arcel) ( Subdivision)
HOMEOWNER: P — S y�G--C�
(Home 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 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 AND SHALL BE ON THE JOB AS SUPERVISOR.
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HOMEOWNER SIGNATURE
BUILDING PERMIT
10. Do any signs exist on the property? YES NO
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property. YES NO
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This col— to be f!J-I,&d in
by the Banding Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
# of Parking spaces
# of Loading Docks
Fill:
(volume & location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledger
DATE: ��( � APPLICANT's SIGNATURE
NOTE: Issuance of a zoning permit does not relieve an applio nVn burden o oomply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Pubiio Works and other applicable permit granting authorities.
FILE if
! #
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Fi 1 e No DEPT'OF BUILDING INSPEt;TiQiVS
NORTHAMPTON f.! 01061
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: 4\ C\',.-At )r�O�ACc C
Address: ,-I ��I
2. Owner of Property:
Address: Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Street Address:
hh �, �� �
Parcel Id: Zoning Map# C��� �— Parcel# ���� �� District(s): �J r
(TO BE FILLED IN BY THE BUILDING DEPARTMENT
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
C tL ) e-_
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW ✓ YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained ,date issued:
(FORM CONTINUES ON OTHER SIDE)
FILE # �-
J
APPLICANT/CONTACT ERS ADDRESS/PHONE: C
PROPERTY LOCATION:
MAP 1:1-Z15-el PARCEL: 23 ZONE
THIS SECTION FORMFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
-ENCLOSED REQUIRED DATE
Flpt- Paid
lRuflding Permit Filled out
FP,-psaid
Type of Constairtion-
Addotinn to Existing
MfFOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION: `
Approved as presented/based on information presented
Denied as presented:
Special Permit and/or Site Plan Required under:§
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under:§ w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
ermit fro C servation Commission c�
WK
ignature of g Inspector Date;'
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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City of Northampton REQUIRED INSPECTIONS
$ e 1. Footings and Walls
BUILDING DEPARTMENT
2. Structural Components in Place*
3. Complete Building*
No. 631 Office of the Building Inspector
Zoning Form No. 960059 Date-7/28/95 Fee$20 Check# 5055
Page, 25C Parcel 236 , Zone URB Section 127 ❑Yes ®No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Michele Kirouac before Building Inspections
has permission to install an above pool Inspection on Site—Foundations
situated on 189 Bridge St. 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
** Install per Manufacturer's information: windows,vinyl siding,roofs Smoke Detectors (Fire Department)
and woodstoves
Other
THIS CARD MUST BE DISPLAYED IN A CONSPJC�JOUS L E O r P MISES
Certificate of Occupancy
uilding Inspector
°���"•� City of Northampton REQUIRED INSPECTIONS
1. Footings and Walls
BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
No. 631 Office of the Building Inspector
Zoning Form No. 960059 Date 7/28/95 Fee$20 Check# 5055
Page, 25C Parcel 236 ,Zone URB Sectio,i 127 ❑Yes ®No
TMTJ
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Michele Kirouac before Building Inspections
has permission to install an above pool Inspection(n Site—Foundations
situated on 189 Bridge St. Inspection of Plumbing—Rough
provided that the person accepting this p°rmit shall in every respect 1mvection A Plumbing—Finish
conform to the terms of the application on file in this office, and to the �° as Inspection
_- -
provisions of the Statutes and the Ordinances relating to the Construction, t ` .: `` Inspectio n of Wiring—Roug -� 1
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation d Inspection of Wiring—Finish , '
of this permit.Expires six months from date of issuance,if not started. L0 "' K` Building Inspection—Rough
Note:A certificate of occupancy will be issijed by this office upon return f
1 M y`/` Insulation Inspection
of this card signed by the Plumbing,Wiring and Building Inspectors. ,. _ �j
'P Building Inspection—Finish
** Install per Manufacturer's information: windows,vinyl siding,roofs { ;� Smoke Detectc.rs (Fire Department)
and woodstoves e, N
Other
THIS CARD MUS B DI;~ L YED IN A NTP�CJOUS L 'E O P MISES
Certificate of Occupanc
building Inspector
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