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DEPARTMENT OF BUILDFNG INSPECTIONS
INSPECTOR 212 Main Strcct ' Municipal Building �.
Northampton, Mass. 01060
2 21996 i ,
9014EowNF-R LICENSE EXEMPTION
(Please Print)
DATE DEPT OF SUiLDMG
JOB LOCATION:
(Map) (Parcel ) (Subdivision)
HOMEOWNER: a a i F EL 4 g c, !(u
(Name & Address )
ti(c{S f� tc��:P )WSJ Flo+ ��c )r�c_ss _ �"ySeiy6, Tz-
( Home Phone ) («ork Phone )
The current exemption for "homeowners" was extended to include
Owner-occupied Dwellinqs 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 . DIR780 Section 109. 1 . 1
DEFINITION OF HOM-F-OWNER: 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 homeo%'gner . Such "homeowner" shall submit to the Buildina
Official , on a form acceptable to the Building Of'ficial , that he/she
shall be responsible for all such work performed under the buildinq
permit .
As acting Construction Supervisor your presence on the job site
will be recruired 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 SHE JOB AS SUPERVISOR.
HO E
MEOWNR SIGNATURE
BUILDING PERMIT
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
�,-�t� ! Additions
NORTHAMPTON, MASS. -�/ ` 19 �='
! Repair
' APPLICATION FOR PERMIT TO ALTER
Garage
1. location � �� '' � Lo[No.
2. Owner's name nRt +I } Inc Address L4 4 /5'1d )CJ t-- I�,e � �7 e
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alterations z f 2 .1 t
6. New Porch i
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. �1 j
Signature of esponsrble appricant
Remarks
10. Do any signs exist on the property?. YES NO N/
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NOi x
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This cola 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
' &paved parking)
pf -Parking Spaces
of Loading Docks
Fill:
A vol-time-4 location)
13 . Certification: I hereby certify that the information contained herein
rf is true and accurate to the best of my knowledge.
DATE: � ` l' A� r APPLICANT'S SIGNATURE
NOTE: lass- oe o f a zoning permit does not relieve an applicant's burden to oo ply with all
zoning requirements and obtain all required permits from the Board of Heaith,'Conservation
Commission, Department of Publio Works and other appiioable permit granting authorities.
FILE #
MAR 2 21996
File No. C
i DEPT OF S "i r�°
PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: '7`/S �cs% ' Telephone:
2. Owner of Property:
Address: Telephone:
3. Status of Applicant: _Owner Contract Purchaser Lessee
Other(explain):
FF�
4. Job Location: '
- i
Parcel Id: Zoning Map# Parcel# District(s):
(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):
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.
Has a Special Permit/Vadance/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?
i
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document#
.. 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)
L5 l'? _ FILE # 9 6 9 7 4
MAR P
2 21996 9
P QN"A T PERSON:
DWM
W :'
PROPERTY LOCATION:
MAP / 7 PARCEL: ZONE �
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Fee PAid
/'' _ z '—
���X)rcwiant Statement or T.irenqe;�
3 Sets of Plan-, I Plot Plan
Lb
THE P OWING 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
!Permit from Conservation C ission
Signature of Building Insp Date
NOTE:Issuanoe of at zoning permit does not relieve an appiioant's burden to oomply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authoritles.
City of Northampton REQUIRED INSPECTIONS
• 1. Footings and Walls
BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
No.
161 Office of the Building Inspector
Zoning Form No. 960746 Date 3/25/96 Fee $40.00 Check# Money Order
Page, 17B Parcel 007 ,Zone RR Section 127 ❑ Yes ® No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Henrietta Kelly before Building Inspections
has permission to repair eve & rotted porch deck from tree damage. Inspection on Site—Foundations
situated on 448 Bridge Road 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 LAC ON TW PRE ISES
1
Certificate of Occupancy
Building Inspector
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