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DEPARTMENT OF BUILDING INSPECTIONS
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INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
HOMEOWNER LICENSE EXEMPTION
DATE: J� 3 (Please Print)
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JOB LOCATION:
(Map), (Parcel) _ (sub ivision)_
HOMEOWNER: v-
_ (N me & Address y 3�2�- C%
(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 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 #
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. T"32 Alterations
so NORTHAMPTON, MASS. - � 19� Additions
P APPLICATION FOR PERMIT TO ALTER Re air
Garage
1. Location �,`� ( r �✓ / .�����('/' F' i`1'r'/� Lot No.
2. Owner's name S 'y 1,9M k6 , A a/7fl,'f a /V Address
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition /-ilk J 1,9 A 6) /-C' a /"7 c/
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 o t:-
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The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
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Signature of responsible apptican
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Remarks
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Date Filed 93 y 0009 1 J File No. I r7A- I I I
ZONING PERMIT APPLICATION (§10. 2) u Rf\/ WSP
1. Name of Applicant:Z(C-CU6,�-/--i./-e " l7i7� �G� N7
Address : /� (�/r� P �� F/ 0 ofTelephone: %j X 3_?- �C5
2 . Owner of Pr9per�t
Address :. /= Cf "P®/(- _ Telephone:
3 . Status of Applicant: ,-Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# i `7 P\ Parcel# 111 ,
Zoning District(s) (include overlays) t
Street Address 1 ,E5 - A, e. Flo ,
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
%Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6 . Narrative Descripti. of Proposed Work roje t: (Use additional �h)ets
if necessary) 1 ay/ '17 J ,J
7 . Attached Plans : Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained herein
is tru and accurate to the best of my knowledge.
Date: `�� Applicant' s Signature: �'' ��
4�1 Ly�
THIS SECTION FOR OFFICIAL USE ONLY: ,
�p roved as THIS
on information presented
Denied as presented--Reason:
Special Permit and/or Site Plan Required:
i din Required: Variance Required:
Signa re of B ng Inspector 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, Conservation Commission, Department of Public Works and other applicable permit granting authorities.
„�. 'Miii AND
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PERMIT APPLICATION CHECK LIST
PAGE f `7 A PLOT f ' ZONE W.-ST YES NO DATE
1 . ZONING FORM APPLICATION ° ieY� Gt L-- 4- 15- 93
2 . PERMIT APPLICATION
3 . OWNER OCCUPANT STATEMENT LIC A IF NOT
4 . 3 SETS OF PLANS /PLOT PLAN
5 . NEW CONSTRUCTION
6 . CURB CUT
7 . WATER AVAILABILITY FORMS
8 . REMODELING INTERIOR
9 . ADDITION
10 . ACCESSORY STRUCTURE L'
11 . SIGN / AWNI
1 2 , PERMIT FE - CHECK ONLY - MONEY ORDER o o L---
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 UNDER SECTION 127 - CMR 780
15 . FORM A
16 . FILL
COMMENTS :
�re ui� d Poo L_
City of Northampton REQUIRED INSPECTIONS
A 9 1. Footings and Walls
BUILDING DEPARTMENT 2. Structural Components in Place*
3. Complete Building*
No. 222 Office of the Building Inspector
Zoning Form No. 000 919 Date a i 3 Fee $40 - Check# 0564
Page, 17A Parcel ill Zone URA/WSP Section 127 ❑ Yes ❑ No
BUI]LDINGPERMI r-I-I
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Marguerite H a n n i f a n before Building Inspections
has permission to Put In An Above Ground Pool Inspection on Site—Foundations
situated on 15 Claire Ave . , Florence Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
confon n 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 CONSPIC CE ON THE PREMISES
Certificate of Occupancy
spector
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