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17C-171 (6) PERMIT APPLICATION CHECK LIST PAGE /I G PLOP... r J ZONE YES NO DATE AppLrcATIoN 2 . APPtIbQlXZQM-- 3 L C. # IF NOT 3 SETS OF PLANS /PLOT PLAN 5 . NEW CONSTRUCTION 6 . CURB CUT T. WATER- AVAILABILITY S 8 . REMODELING- INTERIOR 9 . ADDITION 10 . ACCESSORY U SIGN Z AWNING 2 . PERMIT FEE LONLY - WONEy O D a w .: 13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE 14 . UNDER SECTION 127 - CMR 780 15 . FORM A 16 . FILL COMMENTS : d' r o�.�wurpro ; ` • ,Qdassacllaaette of X=t4aillpflan vt DEPARTMENT OF BUILDING INSPECTIONS INSPECTOR 212 Main Street ' Municipal Building ' Northampton, Mass. 01060 " HOMEOWNER LICENSE EXEMPTION (Please Print) DATE: 1 JOB LOCATION: �(Map) ()?arce )� t�j (Subdivision) HOMEOWNER- (Name & Address) (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 az 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 # z � T � a O > Z Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations NORTHAMPTON, MASS. 19 Additions APPLICATION FOR PERMIT TO ALTER Repair a Garage Location �'//0 — Lot No. 2 Owners name E A h) G r d f A- 5 Address - 3. Builder's name ''"' Address 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 13. Siding house 14 Estimated cost C"r G �-- The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. V Cc--L, l Signature of responsible app icant Remarks Date Filed File No. ZO INd PERMIT APPLICATION (510. ) r I. Name of Applicant: Ld 6?,-v-4 1 Address :-- S �c -yam ,. v Telephone: 2 . owner of Pro e ty: )F-<% Cj &-v- AJ k i N-5 Address : Su e, v Telephone:_5—c- 3 . Status of Applicant: Owner Contract Purchaser Lessee Other (explain: ) 4 . Parcel Identification: Zoning Map Sheet# 11C arcel# / 1/ Zoning District (s) (include o =rlays) r Street Address (p ,L Required 5 . Exis nq Proposed -by Zoning Use of Structure/Property (if project is only interio work, skip to #6) Building height %Bldg. Coverage (Footpr 'nt) Setbacks - fron - si L: R: L: R: - ar Lot size Frontage Floor Area do %Open Spa (Lot area minus buildin and parking) Parkin Spaces Load ' Sigai s Fill (volume & location) 6 . Narrative Description of,-Pro gosed Work/Project: (Use additional sheets if necessary)_ G Y o c 42— 'r 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 knowled e. Date : � Applicant' s Signature : THIS SECTION FOR OFFICIAL USE ONLY: Approved as presented/based on information presented Denied as presented--Reason : Sp ia4Red:' ' and/or Site Plan Required: Variance Required: gnat g Inspector C� at 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 f7ranting authorities. it,71- V City of Northampton REQUIRED INSPECTIONS DEPARTMENT 1. Footings and Walls BUILDING 2. Structural Components in Place* 3. Complete Building* No. ( 367 Office of the Building Inspector Zoning Form No. 002586 Date r ;as Fee 20 neck# 1632 Page, 17C pal 171 ,Zone URB Section 127 ❑ Yes No BMDING PERM I *Plumbing and Electrical Inspections required THIS CERTIFIES THAT Edward Adkins before Building Inspections has permission to Reroof house Inspection on Sits—Foundations situated on 26 Sumner Aup_ 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 Manufacturers information: windows, vinyl siding, roofs and woodstoves. Smoke Detectors(Fire Department) Other THIS CARD MUST BE DISPLAYED IN A CONSPIC O S PL ON THE PREMISES Certificate of Occupancy -- g Inspector