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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. lq Additions
' APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location ` l{d .r�l l /1. Lot No.
2. Owner's name. Address
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
A. Addition �'�`(
5. Alteration
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- J�
The undersigned certifies that th `above state ents are true t he best of his, her
knowledge and be ref.
� t �
Signature of responsible aypllcanl
Remarks
�O�Z itnt[ '0
' 9 Crzf of x.oxtf Riil-pforn
DEPIRTMENT OP BUILDIT(C INSPECTIONS
INSPECTOR 212 Mnin Strcct ' Municipal Building
Northampton, Macs. 01060
HOMEOWNF-R LICE24SE EXEMPTION
( Please Print)
DATE: �t /, �! SL � f 2
JOB LOCATION =
( Map) (p rcel ) ( Subdivision )
HOMEOWNER: `�'� �Tr' �Er'�/ �i� (_
��>(Name & /Address )
The current exemption for "homeowners'' was extended to include
Owner-occupied D-wellinGs or one ( 1 )or two (2) >=ami 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 supery i so- . OPigX80 Section 109 . 1 . 1
DEFINITIOIi OF ROtr?OWNER: Person( s ) who owl, a parcel or land on
which he/she resides or intends to reside , on c here is , or is
intended to be , a one or two family dwelling , —tacked 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 subni t to the Building
Official , on a form acceptable to the Building O_- cial , chat '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 1S2 (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" certifie m
s and assues responsibility
for compliance with the State Building Code , City of Northampton
Ordinances, State and Local Zonin Laws and' State of Massachusetts
General Laws Annotated AND AL 1 BE_ THE AS S RVISOP.
HOMED SIGNATURE
BUILDING PERMIT (� N
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J.W. Simpkin
28 Strawberry Hill
Northampton, MA 01060
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 COMPLE'T'ED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This colu= to be filled in
by the Baildiay Department
Required
Existing Proposed By Zoning
Lot size 11f ,aka - ,
Frontage Ci '16 r jo 0
Setbacks - O j
- side L: R: L:-&-5- R: 9
- rear
Building heights a
s
Bldg Square footage
%Open Space:
Lot area minus bldg /
' &paved parking) CC Cj
# pf, -Parking spaces
of Loading Docks
Fill:
':1 vol-lime--& location)
13 . Certification: I hereby certify that themat 'o, conk 'ned h71,
in
is true nd to the best of my k ovule e' ''
j G.. f' L;�ccurate
DATE: UC APPLICANT's SIGNATURE
NOTE: Issu noe of a zoning permit does not relieve an as plloant's burden to dompl y_witf „ ijA
zoning requiraments and obtain all required permits from the Board of Health, Co141ervation.. ,
Commission, Department of Publio Works and other appiloable permit granting authorities. : ),
ilt',r. FILE #
Fi1e No. I 1
,
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR P=T ALL INFORMATION
c
1. Name of Applicant:
Address: �' `� /Y /'/�.''� jl Telephone:
2. Owner of Propely:
Address: Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: c� � %
Parcel Id: Zoning Map# Parcel# J District(s):
R
O BE FILLED IN BY THE BUILDING DEPARTMENTT�
5. Existing Use of Structure/Property
s
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
�. r
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/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?
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—k— 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)
i
FILE # ��
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE:
PROPERTY LOCATION:
MAP 7 PARCEL: h' ! ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Fee pgid
TVnP nf CnnTtrnrtipn- ._
New Cnnctmetinn
to Existing_ r
z_., .
T FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION-
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 mmission
Signature of ui g r Da
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.
City of Northampton REQUIRED INSPECTIONS
e 1. Footings and Walls
• BUILDING DEPARTMENT 2. Structural Components in Place*
I Complete Building*
No. 894 Offlice of the Building Inspector
Zoning Form No. 961520 Date 9/26/96 Fee 20.00 Check# 811
Page, 17C pal 53 Zone URA Section 127 ❑ Yes No
BUI]LDINGPERMI F f
*Plumbing and Electrical Inspections required
THIS CERTHUS THAT J w Simpkin before Building Inspections
has permission to construct 12' x 16' tool shed Inspection on Site—Foundations
situated on 28 Strawberry Hill Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the tenors 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 ON P ISES
Certificate of Occupancy
Building Inspector �� __