17C-056 (3) a
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Miscellaneous Additions,Repairs,Alterations,etc. Tel..No.�Jg(0`s Alterations
NORTHAMPTON, MASS. rr �� 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
_ Garage
1. Location Lot No.
2. Owner's name\ J-(--C4 OCL,-ta t" C Gk r to Address 1-1q
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished? Yl Z)
S. 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�5(yn.00
Remarks
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible app,icanl
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Miscellaneous Additions,Repairs,Alterations,etc. Tel..No.�Jg(0`s Alterations
NORTHAMPTON, MASS. rr �� 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
_ Garage
1. Location Lot No.
2. Owner's name\ J-(--C4 OCL,-ta t" C Gk r to Address 1-1q
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished? Yl Z)
S. 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�5(yn.00
Remarks
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible app,icanl
9 B �Zixsa�ccfruacUa
DEPARTMENT OP BUILDrNG INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Macs. 01060
HOMEOWNER LICENSE EXF-1=ON
� �( q / (Please Print)
DATE; �fJ �j
JOB LOCATION: /�42,
(Map) (parcel? ( Subdivision)
(Name & ddress )
( Home Phone ) (Work Phone )
The current exemption for "homeowners" was extended to include
Owner-occupied Dwellings of one ( 1 )or two (2) fami I 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 Bui ldina
Official , on a form acceptable to the Building Official, 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 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.
HOMEOWNER SIGNATURE
BUILDING PERMIT
Y
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 column to be filled in
by the Building Department
.tj . c.•ertiticat.ion: I ,hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DA'Z'E: APPLICANT's SIGNATURE
NOTE: Issunnoe at n zoning permit does not relieve n ap li Ys burden to oompty with all
xoning requirements and obtain nil required permits i m onrd of Health, Conservation
Commission, Department of Publio Works and other app able permit granting authorities. 1
;'!. FILE if
Existing
Proposed
Required
By Zoning
Lot size
Frontage
Setbacks - frnnt
- side
L: R:
L: R:
- rear
Building height
Bldg Square footage
%Open Space:
'(Lot area menus bldg
&paved parking)
of -Parking spaces
` (of Loading Docks
Fill:
'4vol-time--& location)
.tj . c.•ertiticat.ion: I ,hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DA'Z'E: APPLICANT's SIGNATURE
NOTE: Issunnoe at n zoning permit does not relieve n ap li Ys burden to oompty with all
xoning requirements and obtain nil required permits i m onrd of Health, Conservation
Commission, Department of Publio Works and other app able permit granting authorities. 1
;'!. FILE if
�j� C
" 6N% File No
` ZZONING PERMIT APPLICATION 010 . 2
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: 56�c G< '( ` �? b—C w
Address: � ���V 1� tX�J� - ` (��1 C�_ Telephone:
2. Owner of Property: Sc' ' C
Address:
Telephone:
1 Status of Applicant: V Owner Contract Purchaser Lessee
Other (explain): �1
4. Job Location: 1`14 �i�s 1l�J� ��� ��Q -' ( 'c)
Parcel Id: Zoning Map# � Parcel# l District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property (ems L 'k-f-\
6 Description of Proposed Usel rk/ProjectlO�ccu ation: (Use additional sheets if necessary):
1 e YYID �1 L c 'AZ� -
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.
FQ
E
Has a Special PermitNariance/Finding ever been issued for/on the site?
NO DON'T KNOW 4,z _ 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#
Does the site contain a brook, body of water or wetlands? NO�DON'T KNOW
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)
YES
FILE #_ '
s i
iAPPLICANT/CONTACT PERSON:
PROPERTY LOCATION:
MAP ���� PARCEL:
LL
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REOUIRED DATE
. . . . .IH _ .Tj _ . .
v 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
Septic Approval-Bd of Health
Permit from Consery
Signature
Water Availability Sewer Availability
Well Water Potability-Bd Health
mmiss
NOTE:tssuanoe of a zoning permit does not relieve an applioant's burden to oompty with ail
zoning requirements and obtain ail required permits from the Board of Health. Conservation
Commission, Department of Publio Works and other appiioable permit granting authorities.
/ 1 1 1 r 1 1 ■
■-
E.ra re 1 1 1 1
_ 1 r
r9. 1 1 11 . , 1
v 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
Septic Approval-Bd of Health
Permit from Consery
Signature
Water Availability Sewer Availability
Well Water Potability-Bd Health
mmiss
NOTE:tssuanoe of a zoning permit does not relieve an applioant's burden to oompty with ail
zoning requirements and obtain ail required permits from the Board of Health. Conservation
Commission, Department of Publio Works and other appiioable permit granting authorities.
City of Northampton REQUIRED INSPECTIONS
• 1. Footings and Walls
BUILDING DEPARTMENT 2. Structural Components in Place*
I Complete Building*
No. 263 Office of the Building Inspector
Zoning Form No. 960854 Date 4/18/96 Fee $40.00 Check# 3956
Page, 17C parcel 56 ,Zone URA Section 127 ❑ Yes 0 No
BUI]LDINGPERMTI
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Jacqueline Currie before Building Inspections
has permission to remove old tub & install new tub Inspection on Site—Foundations
situated on 174 chestnut 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
Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON THUREMISEO
Certificate of Occupancy
nil - g Inspector V�
(,ofN !?:411!SIoY !