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x- Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS./``' s ° 19_22 Additions
APPLICATION FOR PERMIT TO ALTER Repair
,,C / Garage
1. Location ��/�°� '� �" / e '1" Lot No.
2. Owner's name] c'�Y��9 a �. 'Y C Cr Address/ ��L iC.. 27 •
3. Builder's name Address
Mass.Construction Supervisor's License No._ Expiration Date
4. Addition
5. Alteration X-G
6. New Porch
7. Is existing building to be demolished? i
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-
The undersi ed certifies at he a ve statements are true to the best of his, her
knowledge d belief.
sag zure ojresponsible applcanz
Remarks
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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
r HOMEOWNER LICENSE EXEMPTION
-,�� (Please Print)
DATE:
Z '� I
JOB LOCATION: 4�_j
(Ma •) jargel) ( Subdivision)
HOMEOWNER: IV
Address )
(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 resides 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 St e Building Code, City of Northampton
Ordinances, State and Local Zoning aws, sand State of Massachusetts
General Laws Annotated.
HOMEOWNER SIGNATURE 't1hV1V
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 cols to be filled in
by the Building 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
' &paged parking)
,# of -Parking spaces
4 fof Loading Docks
Fill:
-(vol-time--& location)
13 . Certification: I hereby certify that the i format n ntained herein
is true and accurate to the best of my kno Sedge j`
D?4TE APPLICANT's SIGNATU 1.
NOTE: Issunnoa of a zoning
g permit does not relieve an applicant's," urden to comply w(ti�,,all
zoning requirements and obtain all required permits from the Ego of Health, Conservation
Commission, Department of Publio Works and other applioabie rmit granting authorities.
FILE if
File No.
1
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PR1W T ALL INFORMATION
1. Name of Applicant: sriY G ell? �r
Address: �f l ��C/ ,�rl/L.Telephone:
2. Owner of Property: C�� C
Address: // �i(//D!o/� ��(/(Telephone: �r;C
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location., i
i< -t
6
Parcel Id: Zoning Map#_� Parcel# District(s): �
(TO 13E FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property �f�,��
6. Description of PRroposed Use/I�V'ork/P ect/Occupation: (Use additional sheets if necessary):
y' ,2 vy '
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/I--inding 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)
t ,
FILE # j J U J
APPLICANT/CONTACT PERSON: 3
ADDRESS/PHONE:
PROPERTY LOCATION:_
MAP PARCEL: ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FIT LED 0
Fee Pahl
Rididinv Permit Filled mit
Fee Pair! <�
Tvne of rnngtnirtinn-
New Cnngtrurtinn
Remnrleling Inter
Addition to Fxigtina
Arr"snry Rtrurtnre
Building Plans Tnclurlerl-
1 –
bets of Plans /Pint Pl in
THE LLOWING ACTION:ETAS BEEN TAKEN ON THIS AP ICATION:
Approved as presentedfbased 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:
0—Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
Permit—from Conservation mission
Signature of Building or ate
NOTE:Issuance of a zoning permit does not relieve an applicant's burden to comply with ail
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Public Works and other applicable permit granting authoritles.
City of Northampton REQUIRED INSPECTIONS
} ' 1. Footings and Walls
BUILDING DEPARTMENT
� 2. Structural Components in Place*
3. Complete Building*
No. 462 Office of the Building Inspector
Zoning Form No. 962305 Date 6/2/97 Fee$20.00 Check# 1304
Page, 28 Parcel 45 ,Zone SR Section 127 ❑ Yes ® No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Donna Coyle before Building Inspections
has permission to reshingle roof over 1 layer Inspection on Site—Foundations
situated on 69 Cahillane Terr Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conforrn 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
7,4-:---- -- A T....�.�...:.... F D .1,4;_— thn 0'#. of XTnrthao "tnn
LV12lllILGl1[U1l.G al1U 111aly"u0n of 1JUrllilllra ul ulV �.rty v1 iwiu u AF—A.
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 CONSPICUOUS ACE O MISES
Certificate of Occupancy
Building Inspector