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29-466 (5) a T � 3 c CLn z pm Z cn O l z _ Fri ~ C i Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations NORTHAMPTON, MASS. 19 Additions APPLICa ATION FOR PERMIT TO ALTER Repair Garage 1. Location l CPC 5''T'V p E W Die Lot No. 2. Owner's name L Y A V RCA 4 A&I Address e-a54- br 3. Builder's name L.11-IA,(A,( o cc,a an Address /�C'✓r4 r�l e.w br, Mass.Construction Supervisor's License No. Expiration Date 4. Addition 5. Alteration 6. New+Pemh F2otiT 5%EP5 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- pa The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. Si azure of responsible app icant Remarks A-%0 La 14 011 At al ri- fo AJ 4- d Q . Ocr,�•P Q��. C.o u� 1QT� r� 7e Zt��ZK41�l �— �o 3 Uzi Isfmct�a�»�f�rr e tn nt as I AC 4 tit,I _ DEPARTMENT OA BUILDMG INSPEG7lON5 INSPECTOR 212 Mnin Street ° Municipal Building 0.� Northampton, Macs. 010G0 23 HOMEOWNER LICENSE P..XZMPTION (Please Print) DATE: JOB LOCATION : )S C2C.srV 1 C w, D x- (Map) (parcel ) ( Subdivision ) HOMEOWNER: ,Ly,Jnt REA4A ' (Name & Address ) ( Hone Phone ) (Work Phone ) The current exemption for "homeowners" was extended to include Owner-occupied D-wellings of one ( 1 )or two (2) fami 1 es and to allow such . homeowner to engage an individual for hire who does not possess a license , provided that the owner acts as supervisor . (1MR780 Section 109 . 1 . 1 DEFINITIOii OF ROtf?OwNSP.: Person ( s) who own a oarce l of land on which he/she resides or ini_ends to reside , on -wh.c:h _here 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 0-f = cial , that he/she shall be responsible for all such work per performed under the building mit . As acting Construction Supervisor your presence on the job site will be reauired from tine to time , during and upon, completion of the work for which this pernit 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 i 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 iState of Massachusetts t General Laws Annotated AND SHALL BE ON THE JOB AS SUPERVISOR. HOMEOWNER SIGNATURE c BUILDING PERMIT (; M1 1 r 1o. Do any signs exist on the property? YES NO ✓ ! 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 MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. Thi a colm= to be filled is by the Building Department Required Existing Proposed By Zoning Lot size Frontage Setbacks -frnnt - side L: R: L: R: - rear Building height Bldg Square footage %Open Space: (Lot area minus bldg &paved parking) # bf -Parking spaces # of Loading Docks Fill: {vol-t,me--& location) 13 . Certification: I hereby certify that the information contained herein is t e and accurate to the best of my knowledge. DATE: �4 ,.!? i e; APPLICANT'S SIGNATURE NOTE: f u noe of a zoning permit does not relieve an appi�iovint's burd4n to comply with all zoning requirements and obtain all required permits from they Board of Health. Conservation Commission, Department of Public Works and other applicable permit granting authorities. FILE if w 3 G / File No. - ZONING PERMIT APPLICATION (§10 . 2) PLEASE =..El OR PRINT ALL INFORMATION 1. Name of Applicant: L yn!N R E A G A n1 Address: 15 C2 E 5-r V I E W lD F'. Telephoner 2. Owner of Property: Lyn!ni IDEA C,AN Address: f S C2 i s V tC w aI Telephone:_ 3. Status of Applicant: y'Owner Contract Purchaser Lessee Other(explain): 4. Job Location: 15 C 2eST j cur bp— Parcel Id: Zoning Map#� Parcel# District(s): - l � (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property ` 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): CZ-`-PLACE r-r,,n, T 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/Vadance/Finding ever been issued for/on the site? NO DON'T KNOW YES IF YES,date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DONT KNOW ✓ YES IF YES: enter Book Page and/or Document# 9. Does the site contain a brook, body of water or wetlands? NO r !- 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) FILE # APPLICANT/CONTACT PERSON: ADDRESS/PHONE: PROPERTY LOCATION: zi MAP_ Z,� PARCEL: 6,6 ZONE THIS SECTION FORAFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM MLED 0111 Fee Pnid cam' New Cnnqtrnrtinn Rnfl,d no, lam Tnrhided- f _ 7 P THE�QLLOW]NG ACTION HAS BEEN TAKEN ON THIS APPLICATION: Approved as presented/based 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 !Permit from Conservation Co ission Signature of Building Ins ate ` NOTE:lssuanoe of a zoning permit does not relieve an applioants burden to oomply with all zoning requirements and obtain ail required permits from the Board of Health, Conservation Commission, Department of Publio Works and other applioable permit granting authoritles. � z �. 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