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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 6 ` O'� 'f Alterations
NORTHAMPTON, MASS tj:I 19 Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
Garage
1. Location E- 157-- t-/` ,& >~ Lot No.
2. Owner's name [_/D.X-A HAi-17f?,0-,'C Address kl f W—
3. Builder's name S A-rl �-_ Address
Mass.Construction Supervisor's License No. OD f/ J Expiration Date_S1 X1(0
4. Addition S-rD rc S /L1)c9 2 K_b f,1✓t-
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 true to the best of his, her
knowledge and be ief.
Signature of responsible app icant
a
Remarks ��
�OO�
V 6 b �ssanchuatta t
DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building '
Northampton, Macs. 01060 4
HOMEOWNER LICENSE EXEMPTION
(Please Print)
DATE- `
JOB LOCATION:
(Map) (parcel) (Subdivision)
1
HOMEOWNER: _ o I�h I/� /F OA- -E7 lLG I
(Name & Addre s)
511V/1l%
( 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 AND SHALL BE ON THE JOB AS SUPERVISOR.
7
HOMEOWNER SIGNATURE
BUILDING PERMIT #
10. Do any signs exist on the property? YES NO V
IF YES, describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property.?YES NO
IF YES,describe size,type and location:
11_ ALL INFORMATION MAST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This co 7— to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - f rant 22--
- side 4-: 3 4 _R: L:4R: L� c�
- rear f y „ _
Building height �r
Bldg Square footage -11v0-5E st
%6p en Space:
(Lot area minas bldg
&paved parking) (�
# of Parking Spaces
# of Loading Docks
Fill:
. (volume & location)
13 . Certification: I hereby certify that the information contained`herein
is true and accurate to the best of my knowledge .
DATE: l..7 APPLICANT's SIGNATURE �,sl
NOTE: lasuanoe of a zoning permit does not relieve an app oa t-s-burden-to oomply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publjo Works and other appliooble permit granting authorities.
FILE- #
t ate—
File No. i r i
I'd(
ZONING PERMIT APPLICATION (§1
PLEASE TYPE OR PRINT ALL INFORMATION
1. x
f x
1. Name of Applicant: F LoY b a N L " S
Address: `d L LAyL LT. FLo2f_NC_�:_ Telephoner b O .7
2. Owner of Property: 5 Art
Address: Telephone:
3. Status of Applicant: f Owner Contract Purchaser Lessee
Other(explain):
4. Street Address: � 1� �c� 'V4
Parcel Id: Zoning Map# /r� Parcel# District(s):_ v
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property Q.�_—5 1. 'QJ, iJ '; L ft L-
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
>( -2
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special Permit/Variance/Finding ever been issued for/on tha site?
NO 1/ DON'T KNOW YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO i/ DON'T KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained ,date issued:
(FORM CONTINUES ON OTHER SIDE)
F FILE # 990277 ,
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE:
PROPERTY LOCATION:
MAP PARCEL:- ZONE G� c
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Fee Paid
/3
CI -1
THE LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presentedfbased on information presented
Denied as presented:
Special Permit and/or Site Plan Required under:§
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under:§ w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under.§ :w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
P it from C ervation Commission
3
gig iature of ldin for - ate
NOTE:issuance of a zoning permit does not relieve an applloanre 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 authoritles.
City of Northampton RE QUIRED INSPECTIONS IV
BUILDING DEPARTMENT 1. Footings and Walls
2. Structural Components in Place*
3. Complete Building*
No. 824 Office of the Building Inspector
Zoning Form No. 960277 Date 9/27/95 Fee$20 Check# 713
Page, 17A Parcel 235 ,Zone UR8 Section 127 CJ Yes No
BUI]LDINGPERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Floyd Andrus before Building Inspections
has permission to construct a 20 x 24 storage shed/workbench Inspection on Site—Foundations
situated on 81 Lake St. - Florence Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the terms of the application on file in this office, and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Finish
of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough
Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection
of this card signed by the Plumbing,Wiring and Building Inspectors.
Building Inspection—Finish
** Install per Manufacturer's information: windows, vinyl siding,roofs Smoke Detectors (Fire Department).
and woodstoves
Other
THIS CARD MUST BE DISPLAYED IN A CON$P,IC PL O THE PREMISES
Certificate of Occupancy
Building c or