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17A-064 n PERMIT APPLICATION CHECK LIST PAGE 7 PLOT rV ZONE 41 �� YES NO DATE 1 . ZONING FORM APPLICATION L- � �� Q 2 . PERMIT APPLICATION 3 . OWNER OCCUPANT STATEMENT LIC . # IF NOT C/ 4 . 3 SETS OF PLANS /PLOT PLAN 5 . NEW CONSTRUCTION 6 . CURB CU 7 . WATER AVAILABILITY FORMS 8 , REMODELING INTERIOR 9 . ADDITION 10 . ACCESSORY STRUCTURE 11 . SIGN / AWNI 12 . PERMIT FEE - CHECK ONLY - MONEY ORDER t/ 13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE 14 , UNDER SECTION 127 - CMR 780 15 . FORM A 16 . FILL COMMENTS : 5b D JJ h+ #rl g �a b j •204 n pT0 a 9 Grxt� x1f Xart alit flan MIMI(Ch Its eIIs DEPARTMENT OF BUILDrNG INSPECTIONS INSPECTOR 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 HOMEOWNER LICENSE EXEMPTION DATE: e3 (Please Print) �(� JOB LOCATION: (MaVIA (parcel) (Subdivision) HOMEOWNER: ,� , (Name & Address) 6 2)37e (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 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. OMEOWNER SIGNATURE r BU ING PERMIT # < n oil * rn a n > w OO 5 > a c ° z Y M / Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No_ ^f f "d Alterations NORTHAMPTON, MASS. i6 hk 191 Additions 1 APPLICATION FOR PERMIT TO ALTER Repair Garage 10 Location .S / = _ Lot No. (2/ Owner's name 6. U6 JV1 1 4 Address__ 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? 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:-�iding house � Co 4. Estimated cost- s � The undersigned certifies that the above statements are true to the best of his, her knowledge end clief. � � ,ra Signature J responsible Irplicant Remarks 11,Zi9"' Z--, Date Filed qaiA�111 (ile No. ZONING PERMIT APPLICATION (§10 . 2 ) J,/.," Name of Applicant: A ell, G ICA166J Address : L6,-t,�JceT eA e p h o n e: Q n 2 Owners of Property: y -r Address -, 22L2 gf ). r/ _,g_-Eil>CE Telephone . 3 . Status of Applicant: ),. OwnerS Contract Purchaser Lessee Other (explain: ) 4 . Parcel Identification: Zoning Map Sheet# Parcel// 0r Zoning District (s) (include over s) , Street Address 5 , Required 5. Existincr Proposed by Zoning Use of Structure/Property (if project is only interior work, skip to #6) Building height %BI dg-.-C-aver e (Footprint) Setbacks - front (5 r - side L: R: =L: R: - rear 11 j Frontage �1 Floor Area Ratio %Open Space (Lot area minus building and parking) Parking Spaces Loading Signs Fill (volume & location) C6 .) Narrative Description of Proposed Work/Project : (Use additional sheets if necessary) (� 7 . Attached Plans : Sketch Plan Site Plan 8 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. Date : V 3 Applicant' sSignatu e� �� THIS SECTION FOR OFFICIAL USE L O Y: " Approved as presented/based on information p resented Denied as presented--Reason: Sp cial' Permit d/or Site Plan Required: F ' di qui d: Variance Required : �q6j �S gnature c or ate 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. i"7,)- City of Northampton REQUIRED INSPECTIONS � e • 1. Footings and Walls BUILDING DEPARTMENT 2. Structural Components in Place* I Complete Building* No. 967 Office of the Building Inspector Zoning Form No. H Date 10/20/93Fee $20 Check# 2536 Page, 17A pawl 64 ,Zone URB Section 127 ❑ Yes 0 No BUI]LDINGVERMIT *Plumbing and Electrical Inspections required THIS CERTH IES THAT Robert Kearney before Building Inspections has permission to Install a garden shed 81x101 Inspection on Site—Foundations situated on 257 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 CONSPICU U PL ON THE PREMISES Certificate of Occupancy g nspector (c�+t )"Ali f 5i 15