17C-183 (6) PERMIT APPLLIICATIO_N CHECK LIST
P-AGE t4 7e PLOT ZONE ��
ES N 0 DATE
ZONT.NQ FOPM LIC IO j_ Jo
2 PERMIT P L _ _ 0
3 , OWNER OCCUPANT UATEMF T L C i► IF NOT ?
L I v
4_, 3 SSTS OF PLANS /PLOT PLAN
6 , NEW CONSTRUCTION
6 , CURB CUT
7 . WA19B r S
8 RE ODELTNG INTERrOR
9 ADDITION
i
10 ACCT SORY STRUCTURE
1 , SIG I G
2 , PERMIT FEE - CHECK ONLY - HONEY O D E `k-13 SPECIAL PEGMIT REQUIRED WITH DEED IF APP _ICABLE
14 , U DER SECTION t27 - MR 780
6 FORM A
16 , FILL
COMMENTS ;
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
a NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location-M CILM4 nflC1` T B �,`rr1C 1 [ Lot No.
2. Owners name I I jon I CIFF11 10 Address J+ CIt(t''`�lh It fDal:
3. Builder's name L? - hemn Address �f l LY el 3S 11 E
Mass.Construction Supervisor's License No. Expiration Date
4. Addition t un I A, x 1(71
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 belief.
l��l t ,&Lun:"L Mn
Signature of responsible app,icant
Remarks /,
Crlf� of Narf4alilpton
� .i�lxsaACltasrtla
DEPARTMENT OF BUILDITNG INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building '
Northampton, Mass. 01060
HOMEOWNER LICENSE EXEMPTION
(Please Print)
DATE:
JOB LOCATION:
(Map) (P rcel) (Subdivision)
HOMEOWNER: f�I)(� I��� � F 0 I g�c�l f7
(Name & Address)
CVIW lIIT SL zi(Y k X11;4, yl3 `may
(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 #
cg-�e 0 011 4
Date File File No.
ZONING PERMIT APPLICATION (510 . 2)
I . Name of Applicant :
Address : Telephoned U
2 . Owner of Property:_-W 1a In - (6X cy.,41 l'O
Address :} t`�,tt` 7��i �`�t'i YT :�a I)fFJ(e Telephone : Sk(,-,a4q y
3 . Status of Applicant :Owner Contract Purchaser
Lessee Other (explain : )
4 . Parcel Identification: Zoning Map Sheet# 1-7e-- Parcel# /$ - ,
Zoning District (s) (include overlays)__________
Street Address r
Required
5 . Existing Proposed by Zoning
Use of Structure/Property a
(if project is only interior work, skip to 6)
Building height
ldg. Coverage (Footprint)
Setbacks - front C)
- side L: R: L: ` R:
- rear if la` ,
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 Proposed Work/Project : (Use additional sheets
if necessary) j iii S
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 : Applicant ' s Signatur
THIS SECTION FOR OFFICIAL USE ONLY;
✓approved as presented/based on information presented
Denied as presented--Reason :
Special' Permit and/or Site Plan Required :
in ng uired: Variance Required : oe
gnat 8 wild pector � DRJee
NOTE: Issuanoo of a zoning permit does not relieve an applicnnl's burclon to comply with all zonin4J requirements and obtain all required permits
from Uic Board of Health, Consorvation Commission, Depnrtmont of Public Works and othar opplicnblo permit granting authorities.
i c"71-
az�Pr
City of Northampton REQUIRED INSPECTIONS
g e
1. Foogs and WaUs
BUILDING DEPARTMENT 2. Struccttural Components in Place*
3. Complete Building*
No. 383 Office of the Building Inspector
Zoning Form No. 001148 Data/28/93 Fee $40 Check# 244
Page, 17C Parcel 183 ,Zone URB Secdon 127 ❑ Yes No
BUI]LDING PERM ivi
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Lynn LaFountain before Building Inspections
has permission to Replace window with door, add deck 12'x10' Inspection on Site—Foundations
situated on 57 Chestnut 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 CONSPIC US P ON T HE PREMISES
Certificate of Occupancy "
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