17A-062 (2) PERMIT APPLICATION CHECK LIST
PAG�PLOT ZONE DATE
ZONING IO N *q�
2 . PERMIT
3 , --OWNER I 0
3 S
5 . NEW CONSTRUCTION
6 CURB CUT
7 WATER
8 . REMODELING INTERIOR
9 . ADDITION
0 , ACCESSORY STRUCTURE
SI
2 , PERMIT FEE - CHECK ONLY - MONEY ORDER .4% 0&3e
3 . SPECIAL PERMIT REQUIRED WITH DEED IF APPL.ICABLE
14 .--UNDER SECTION 127 - CMR 780
5 FORM A
6 . FILL
COMMENTS :
` • '7 �iistaclruscttr
DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060 "
7
HOMEOWNER LICENSE RXFM1'`T'ION (����• ��
OK
(Please Print)
DATE:
JOB LOCATION: G,-e ���( d'/ FL
(Map) (parcel) `-' '(Subdivision)
HOMEOWNER: 4 vi P J er sit 2=., t
(Name Address)
(Home Phone) (Work Phone)
The current exemption for "homeowners" was extended to include
owner-occupied Dwellings 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. 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
conside-red 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 State Building Code,. City of Northampton
Ordinances, State and Local Zoning Laws, and State of Massachusetts
General Laws A notated.
HOMEOWNER SIGMA
BUILDING PERMIT
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
Repair
a /,-?APPLICATION FOR PERMIT TO ALTER
-I Garage
1 I ation k. d• O 1 Lot No.
wner's name L Address `f ) 1 a Z FL a
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. Siding house
14. Estimated cost-
The undersigned certifies that the above statements are we to the best of his, her
knowledge and belief.
Sgnatur of responstble applicant
Remarks
00303_L
Date Filed File No.
ZONING PERMIT APPLICATION
Name of Applicant: l ��� L l a a
Address: 3 _R E L . , —Telephone: Sr,-�4- Z93 S
2�. Owner of Property:__. 540/� e,._
l/ Address: Telephone:
3 . Status of Applicant: l/�wner Contract Purchaser
Lessee Other (explain
4 . Parcel Identification: Zoning Map Sh et# - Parcel# 3,
Zoning District(s) (include over ys) �,t,�'�.-
Street Address
Required
5•
Existing Proposed by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side L: R: L: R:
- rear
Lot size --
Frontage.
Floor Area Ratio
. 00pen Space (Lot area minus /
building and parking) /
Parking Spaces
Loading
Signs
Fill (volume & location)
5 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: Applicant,'s Signatu 1
THIS SEIN FOR FF
OICIAL U ONL
CTO Y:
lLApproved as presented/based on information presented
Denied as presented--Reason:
ecial' Permit nd/or Site Plan Required:
/ in i Requi a variance Required:
gnatur f aTilding Ins e , Date
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,Consorva(ion Commission, Departmont of Public Works and other applicable permit granting authorities.
%el,)-
City of Northampton REQUIRED INSPECTIONS
0 1.e BUILDING DEPARTMENT 2. Struccttural Components in Place*
I Complete Building*
Office of the Building Inspector
No. 748
Zoning Form No. 003081 Date 8/4/94 Fee $20 Check# 0638
Page, r7" arcel ,Zone URB Section 127 ❑ Yes 0 No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Janet Lamanna before Building Inspections
has permission to Install vinyl siding Inspection on Site—Foundations
situated on 243 Bridge OW48ft' 1��4"t 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
** Install per Manufacturers information: windows, vinyl siding,
roofs and woodstoves. Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSP ICUOUS PLACE 9N THE PREMISES
Certificate of Occupancy
Builder cctor
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