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11C-029 (5) PERMIT APPLICATION CHECK LIST PAGE �� PLOT ZONE G iC-/ / ! YES NO DATE 1 . ZONING FORM APPLICATION ✓ 2 . PERMIT APPLICATION 3 . OWNER OCCUPANT STATEMENT LIC . # IF NOT 4 . 3 SETS OF PLANS T PLAN 5 . NEW CONSTRUCTION 6 . CURB CU 7 . WATER AVAILABILITY FORMS 8 . REMODELING INTERIOR 9 . ADDITIO 10 . ACCESSORY STRUCTURE 11 . SIGN / AWNI 12 , PERMIT FE — QjjjC %0 Y — MONEY ORDE /;i ` a 13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE 14 . UNDER SECTION 127 - CMR 780 15 . FORM A 16 . FILL COMMENTS : y z, `v c� r: d It o• r rri a c n Y OO o a tTi Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.NoKe)� Alterations NORTHAMPTON, MASS. 2 a 9 Additions Repair APPLICATION FOR PERMIT TO ALTER ,! D,,�, Garage 1. Location_,( 7 Op Rejyec� 1 !, r Lot No. 2. Owner's name�WP-&RV Address_ ]� ��R r�r�� /° 1 ,'r S 149, 3. Builder's name �� Address C2�N (� P!Al iy 'Y 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 t ` X12. Type of roof , 146 %l9liv 13. Siding house 14. Estimated cost:- J The undersigned certifies that the above statements are true to the best of his, her Cknowledge an belief. Signature of responsible appicant Remarks - i e R. Crif� of Nart4aillpton r o = � J,i�nsaadluaetta DEPARTMENT CF BUILDDT G INSPECTIONS INSPECTOR 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 HOMEOWNER LICENSE EXEMPTION DATE: (Please Print) � © - 9� JOB LOCATION: ( p) (Par 1) (Subdivision) / HOMEOWNER- e J l 4 ' ee4 IVA 0;m Name & Address ) S,p�/"dD�_ (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 at 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. HOMEOWNER SIGNATURE ,� } BUILDING PERMIT # r ' U J � f �. Date Filed 001 File No. ZONING PERMIT APPLICATION (510 . 2 ) f 1. Name of Applican : ti Address : c Telephone: ,5 06 Z r 2 . Owner of Property: Q Te d " Address : 9'0 Telephone : 144 5c- O 02 X- 3 . Status of Applicant: L- Owner Contract Purchaser Lessee Other (explain; ) 4 . Parcel Identification: Zoning Map Sheet# //C, Parcel# , Zoning District (s) (include overlays) Street Address Required 5. Existina Proposed by-Zoning Use of Structure/Property e_,�_, (if project is only interior work, skip to #6) Building height %B1dg. Coverage (Footprint) Setbacks - front - side L: L: R: - rear Lot size Frontage Floor Area Ratio %Open Space (Lot area minus building and parking) Parking Spaces Loading i Signs Fill (volume & location) 6 . Narrative Descr ' tion of�oposed Wo k 0jeC4: Use additional sheets if necessary) 2"- c30 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 : ;D Applicant' s Signature : r / THIS SECTION FOR OFFICIAL USE ONLY: 1� Approved as presented/based on information presented Denied as presented--Reason: SpecIal" Permit and/or Site Plan Required : n ing R it d: Variance Requ71z-7-9 IV ��,„ �-, gnatu e f uilding I r �y� at NOTE: Issuance of a zoning pe does not relieve an applicant's burden to comply with all zoning requirements and obtain all required permits from ft Board of Health,Conservation Commission, Depaitmont of Public Works and other applicable permit granting authorities. O T L V City of Northampton REQUIRED INSPECTIONS BUILDING DEPARTMENT I. Footings and palls � e 2. Structural Components in Place* 3. Complete Building* No. 669 Office of the Building Inspector Zoning Form No. 001498 Date 8/2/93 Fee 20 Cbeck# 1064 Page, 11C parcel 29 ,Zone URA Section 127 ❑ Yes No BUI]LDINGPERMI r I * Plumbing and Electrical Inspections required THLS CERTIFIES THAT Henry R. Pontbriand before Building Inspections has permission to Re-roof with asphalt shingles Inspection on Site.—Foundations situated on 140 Florence 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 CONSPICU U LA O THE PREMISES Certificate of Occupancy