17A-100 4
EERMIT APPLICATION CHECK LIST
P A G -Y S.s NO DATE
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2 , PE LT; _AAALIGA Iou
3 , . E � tk IF NO y'
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4 . -- E PLANS /PLOT PLAN `
5 , NEW CONSTRUCTION
6 , CURB CUT
7 . WATEE AVAILABUITY FORMS
8REMODELING INTERIOR
9 . 6DDITION
10 , ACCEHORY SIBUOTURE
11 , SIGN AWNTNG
2 CHEQK ONLY - ONEY 0 RDER
13 , SPECIAL. PERMIT REQUIRED WITH DEED IF APPLICABLE
J4 UND.ER SECTION 12 - CMR 780
15 , FORM A
16 , FILL
COMMENTS :
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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building 'Y
Northampton, Mass. 01060
HOMEOWNER LICENSE EXEMPTION
,, (Please Print)
DATE: 3
JOB LOCATION:
(Map) (Parcel) (Subdivision)
HOMEOWNER: �. 1
(Name & Add le ss)
(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 ai
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 j
BUILDING PERMIT #
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/ Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 1 J U c1 ,F-7 Alterations
NORTHAMPTON, MASS. 19 Additions
ti
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location a 3 �GQ�1 et,J Cl tom' 1 �= pt) Lot No.
2. Owners name Al LL.�/.'} eV/r L/ Address 5A, A4
3. Builder's name nllJIAMI ZZZ; =- o< -ev All Address S,�7
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' ,��G� /Al y /
13. Siding house
v�
14. Estimated cost:- 7
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature oJrespon !e appeicanl
Remarks
of
0011?i :j
1 P
Date Filed__ File No.
ZONING PERMIT APPLICATION (510 , 2)
I . Name of Applicant : f
Address : Te ephone :
2 . owner of Property: `�` �v]
Address : Telephone :
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain : )
4 , Parcel Identification: Zoning Map Sheet# 1714 Parcel#
Zoning District (s) (inclu P overlays)
Street Address e
Required
5 . Existinq Proposed by Zoning
Use of Structure/Property X, 4 -
(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-,
. %Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6 . Narrative Description of Pr posed 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 : Z, Applicant ' s Signature : S: r !�
_ _ _ V_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
r THIS SECTION FOR OFFICIAL USE ONLY:
i/Approved as presented/based on information presented
Denied as'presented--Reason :
S cial' Permit and/or Site Plan Required :
`nd g wired: _ Variance Required:
S gnat e o Bu r hv at
NOTE: Issuance of a zoning permit does not reliave an appiicnnl's burden to comply with n11 zoning requirements and obtain all required permits
from the Board of Health, Conservation Commission, Dapaitrnont of Public Works and othor nppiicnblo permit granting nuthoritics.
16-71-
City of Northampton REQUHZED INSPECTIONS
BUILDING DEPARTMENT I. Footings and Walls
V t 40 2. Structural Components in Place*
3. Complete Building*
No.
430 Office of the Building Inspector
Zoning Form No. 001219 Date 6/8/93 Fee $20 Check# 316
Page, 17A Parcel 100 ,Zone URA Section 127 ❑ Yes ❑ No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT S.D. Mulvaney before Building Inspections
has permission to Repair/re-shingle roof Inspection on Site—Foundations
situated on 23 Grandview Street 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 PLA O THE PREMISES
Certificate of Occupancy _.
g Inspector