11C-032 (3) PERMIT APPLICATION CHECK LIST
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E NO DATE
2
3 .
3 SETS OF PLANS /PLOT PLAN
NEW CONSTRUCTION
6 , CURB CUT
7 WATER
8 . REMODELING
9 , ADDI
0 , ACCESSORY
11 . SIGN
2
PERMIT E - L
13 . SPEC IAL PERMIT REQUIRED WITH DEED IF APPLICABLE
4 . UNDER SE - CMR 780
5 . FORM A
6 . FILL
COMMENTS :
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DEPARTMENT OF BUILDING INSPECTIONS -
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
HOMEOWNER LICENSE RXEMPTION
f' (Please Print)
DATE:
JOB LOCATION: �� ...., -��
(map) (parcel) ( Subdivision)
HOMEOWNER-
(Name & Address)
31
(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 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 Annotated AND SHALL BE ON THE JOB AS SUPERVISOR.
HOMEOWNER SIGNATURE (
BUILDING PERMIT #
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Rc;pair
Garage
Location q S Tv :A:-e c45, 14 p, Lm No.
2. Owner's name v % �'%/, T T Address % Si JI .�%T t' S
3 Builder's name��te ai m Aj 2 C f Address PO 6,,-,-A I Sr? /t o I 04 �3
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
05AIteration S%A,'>> -+ R S �, �>s 1 t (2 0,0
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
1 iding house
(14. cost- ;�
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible app leant
J ,
Remarks
i
Date Filed File. No.
ZONING PERMIT APPLICATION (910. 2)
1 . Name of Applicant: LA/ /, A_ S
Address: P6 13 4,A y /Q E ,4,e; /�i��. 43 Telephoner
0 owner of Property: 11 7,
Address: S �� t.�s e /T.�,;� ; L�_eds lj.�?, Telephone:
3' Status of Applicant: Owner Contract Purchaser
Lessee Other (explain )
4 . Parcel identification: Zoning Map SheetiItL Parcel# �j�• ,
Zoning Districts) (include overlays). .1
Street Address Uq
Required
5 . Existincr Proposed by Zoning
Use of Structure/Property
(if project is only interior wo k, skip o #6)
Building height
5-.' B1dg. Coverage (Footprint)
Setbacks - front
- side L: R: L: _
- rear
Lot size 1
Frontage-
Floor Area Ratio
. %Open Space (Lot area minus
building and parking) ' y'
Parking Spaces
Loading
Signs
Fill (volume & location
! b • " Narrative Description of Proposed Wor Project: (Use additional sheets
_J if necessary) S771z ; p- `t- P s 1, ""��ai= y1e,e14
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: ���, 9S Applicant's Signatures i
r THIS SECTION FOR OFFICIAL USE (5YNL r r r
ZApproved as presented/based on information presented
Denied as presented--Reason:
Special*' Pepni t and/or Site Plan Required:
finding i d: Variance Required:
S. gna r of Buzldin Inspector t
NOTE: (ssuarm of a zoning porn id does not relieve an applicants burden to comply Willi all zoning requirements and obtain all required permits
from the Board of Health,Conservation Commission,Department of Public Works and otltor applicablo permit granting authoritios.
`C T)-
City of Northampton REQUIRED INSPECTIONS
$ e 1. Footings and Walls
BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
No. 335 Office of the Building Inspector
Zoning Forrn No.
VV'�3222 Late ;%3%9 5 Fee ?2V l:necK fF i'ivitey yr Cie
Page, 11C pal 32 ,Zone URA Section 127 ❑ Yes ® No
BUI]LDINGPERMI rr-I
Gerald Brooks * Plumbing and Electrical Inspections required
THIS CERTIFIES THAT before Building Inspections
has permission to Strip & reshingle roof Inspection on Site—Foundations
situated on 9 Stowell Street, Leeds 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 P A ON PREMISES
Cei Dficate of Occupancy
Building