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GMR780 Section 109. 1 . 1 DEFINITION OF HO EOWNER_ 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 Buildina 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 corrpieti0i, o- t 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- HOMEOWNER SIGNATURE BUILDING PERMIT " a - 4 f fA n :i r i t a > 2 X Oil n 3 O ZZ m Z z 1 � o Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.� � �088y Alterations NORTHAMPTON,.MASS. �ori� 19,�� Additions APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location -34 L.c AI &�IZ Z2&4i xe— Lot No. 2. Owner's name lVa" C"W M Address34 _Ly4&,ad 6�// i%e4 we A&F. dzzaLa 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 0 Method of heating /�6��� �' .ST�/� 6 A66j, ei-o.i 11. Distance to lot lines 12. Type of roof 13. Siding house X ', 14. Estimated cosu- The undersigned certifies that the above statements are true to the best of his, her knowledge and belief. /� n Signature of respo !e app'leant Remarks WA f MW 10. 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. This colimm to be filled by tl:* Feil3i.ag Departm-nt Required Existing Proposed By Zoning Lot size Frontage Setbacks - frnnt - side L: R: L: R: - rear Building height Bldg Square footage %Open Space: (l_Ot area minus bidg &paved parking) of -Parking Spaces of Loading Docks Fill: 4vol-ume--& location) 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of ray knowledge. .1 DATE: APPLICANT's SIGNATURE NOTE: /ssuanoe of a zoning permit does not relieve a applicant's burd to oomply with all zoning requirements and obtain all required permits from the Board of Health, Conservation _ iCommission. Department of Publio Works and other appiioable permit granting authorities. FILE # �C AOp / r Y ZONXNG PERMIT APPLICATION (§10 . 2) "PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: F Ao�ams Tr_ Address: 3,4 _Z�aa jz h:// e=&v C_ h1a. 91&1-a Telephone: 2. Owner of Property:efr�-�ys oie,(.nTelephone: 1, Status of Applicant: ✓ Owner Contract Purchaser Lessee Other(explain): 4. Job Location: Parcel Id: Zoning Map# � � Parcel# ,-" �), District(s): - _l' Z2'2 �—) (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): 7. Attached Plans: ,/ Sketch Plan J 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 I i DON'T KNn01n 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_,,,/ 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 # 9)G S 3 7 Alij� F - i 1'(;wCONTICT PERSON: ADDRESSIPHONE: t Mi f ,, ": bPERTY LOCATION: C-'4f� MAP PARCEL: c ZONE 1e2L2 G4 THIS SECTION FOR-OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE 7.()NTNG Fngm FRIED (MIT Fee P51id lRydiding Permit Filled nvit b/ / 2 ' c c� Own OLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION: '. 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 Co a ion Commissi 0 Signature of Building Inspec ate NOTE:tssuanoe of as zoning permit does not relieve an applioant's burden to comply with ail zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Publlo Works and other applicable permit granting authorities. n N z CD O O rte. 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