05-039 (3) PERMIT APPLICATION QHgCK LIST
PAGE C `a PLOT c'F= l ZONE h-R I �`� YES NO DATE
1 . ZONING FORM APPLICATION �-Y) rlr (J y '7 `�`
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2 . PERMIT APPLICATION L�
3 . OWNER OCCUPANT C IF NO
4 . 3 SGTS OF PLANS /PLOT PLAN ��� �� Ic % '1 CL))
5 . NEW CONSTRUCTION
6 . CURB CU
7 WATER VA L B IT 0 MS
8 . REMODELING INTERI
9 , ADDITIO
10 . ACCESSORY S C U E
11 . SIGN AWNING
7
12 , PERMIT FEE - CHECK ONLY - MONEY ORDER t---
13 . SPECIAL PERMIT E UIRED WITH DEED IF APPLICABLE
4 . UNDER SECTION 127 - CMR 780
15 , FORM A
16 FILL
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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
HOMEOWNER LICENSE EXEMPTION
DATE: �� ��Z (Please Print)
JOB LOCATION:_ G 3 9
��d � (MA�� (�Par_ic �(Subdivision)
HOMEOW NER:
Lytn
(Name & Address) bd S 8 C
(Home Phone) (Work Phone )
The current exemption for "homeowners" was extended to include
owner-occupied Dwellings of six ( 6) units or less and to allow such
homeowner to engage an individual for hire who does not possess a
license, provided that the owner acts as supervisor. '
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 to six 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. Alterations
NORTHAMPTON, MASS. �� 19 r� Additions
APPLICa ATION FOR PERMIT TO ALTER Repair
n c� Garage
1. Location ke^r1 f1 Q � + 35 Lot No.
2. Owner's name-J, LA-06 Sn! Address S
3. Builder's name 6�yn ���-\G N kz Address (a 3 U� i
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 11 O
9. Garage I\JAN- No.of cars Size
10. Method of heating
11. Distance to lot lines
12. Type of roof WS ,
13. Siding house
14. Estimated cost:-
p� The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible applicant
Remarks
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I hereby report that the premises shown on this plan is not located within a Flood
Hazard Area as shown on Department of H.U.D. Federal Insurance Administration Maps,
Community N er 250167-0001A
Identificati n ate Aril 3, 1 8
lU � By:
0 THE NORTHAMPTON CO-OPERATIVE BANK OWNER=
DEBRA E. SMITH AND IRA HELFOND
ID THE AMERICAN TITLE INSURANCE CO.-only LOCATION=
To the best of my knowledge, informa- 551 KENNEDY ROAD, LEEDS, NORTHAMPTON, MASS.
ion and belief, I hereby report that I ,
jve examined the premises and that tills . ALMER HUNTLEYJR.Ok ASSOCIATES, INC.
ispection plat shows the improvement or SURvEYORS •ENGINEERS*PLANNERS
nprovements as located on the premises de- 125PLEASANT STREET P.O. BOX 568
:ribed, that the improvement or improve- NORTHAMPTON, MASSACHUSETTS 01060
ants are entirely within lot lines, and
iat there are no encroachments upon the SCALE
remises described by the improvement or
nprovements of any adjoining premises, �a °f
v 00033 ,)
Date Filed, C-1 �c 2_ '
�, �� File No. 05 o317- ��
ZONING PERMIT APPLICATION (510 . 2) R R / W cS P
I . Name Of Applicant: K�c tycn 3 �t-'3 L--2 p..� j I
Address : f- r U Telephone: -I
2 . Owner of Property:
Address : Telephone:
3 . Status of Applicant: X Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# US Parcel# 03 r
Zoning District (s) (include overlays) P P e
Street Address !y_SL z a3 e-d s/ JR,4
Required
5 . Existina Proposed by Zoning
Use of Structure/Property V.
(if project is only interior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side j, R r°s�� R .-,Cs *k (,Vx
- - 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 Pro osed Work/Project: (Use additional sheets
if necessary)
7 . Attached Plans : _Sketch Plan Site Plan
8 . Certification: I hereby certify that the informat ' n contained herein
is true and accurate to the best of my knowledge.
f Q Ct (C� Z Date: Applicant s Signature: i V,, V`
Y THIS SECTION FOR OFFICIAL USE ONLY: `
SFP 3 0
Approved as presented/based on information presented .
D ied as pr sented
as for D ial :
gnatu e wilding pector Date
NOTE: issuance of a zo rmit does not ras
lieve an applicant's burden to comply with all zoning requirements and obtain all required pormhe
from tho Board of Health, Conservation Commission, Department of Public Works and other applicable pormit grunting authorities.
7/a2 FXAS
City of Northampton REQUIRED INSPECTIONS
$ e 1 . Footings and Walls
BUILDING DEPARTMENT 2 - Structural Components in
Place
3 . Complete Building
No. 628 Office of the Building Inspector
Date September 30, 1992 19
BUI DING P RMIT
M
THIS MAY CERTIFY THAT Judith Leeds/Richard Stonberg Insp. on Site — Foundations
has permission to Construct a 12'x12' deck for portable spa/hot tub Insp. of Plumbing — Rough
situated on 551 Kennedy Road, Leeds Insp. of Plumbing — Finish
provided that the person accepting this permit shall in every re- Insp. of Wiring — Rough
spect conform to the terms of the application on file in this office,
and to the provisions of the Statutes and the Ordinances relating Insp. of Wiring — Finish
to the Construction,Maintenance and Inspection of Buildings in Insp. of Health (Septic Tanks)
the City of Northampton.Any violation of any of the terms above
noted is an immediate revocation of this permit. Expires six Building Insp. — Rough
months from date of issuance, if not started. Building Insp. — Finish
Note: A certificate of occupancy will be issued by this office upon
return of this card signed by the Plumbing, Wiring and Building Smoke Detectors (Fire Dept.)
Inspectors. Gas Inspection
THIS CARD MUST BE DISPLAYED IN A CONS ICUO S PLACE ON THE PREMISES
Certificate of Occupancy
wilding Inspector.