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32C-198 DEPARTMENT OP BUILDFNC INSPECTIONS INSPECTOR 212 Main Street ' Municipal Building ' g�. Northampton, Maas. 01060 HOMEOWNER LICENSE EXEMPTION ( Please Print) DATE JOB LOCATION : � � map) (parcel ( Subdivi,sion ) HOMEOWNER: lJ r c� _= ,rrc� 57— . Name & Address ) ( Horl;e hone } Nork Phone ) The current exemption for "homeowners" was extended to include Owner-occupied D-wellinGs of one ( 1 )or two (2) fami I ies 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 ROKEOWNER: Person ( s ) who own a parcel of land on which he/she resides or intends to reside , on wh_ch there is , or is intended to be , a one or two family dwelling , ac-'ached or detached structures accessory to such use and/or farm structu -es . 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 O-fficial , 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 reauired 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 ma� be' liabl,e for person( s ) you hire to perform work for s 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 z � rfl 3 c „ a CA Z } = Z Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations NORTHAMPTON, MASS. ` 19 ' Additions APPLICATION FOR PERMIT TO ALTER Repair a 1 Garage 1. Location /��t�.1 / S J Lot No. 2. Owner's name Address 3. Builder's name Address Mass.Construction Supervisor's License No. Expiration Date 4. Addition ,Q 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. Signature of responsible app.lcant Remarks Y 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 Z-' IF YES,describe size,type and location: 11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. This column to be filled in by the Building Department Required Existing Proposed By Zoning Lot size Frontage Setbacks - side L• R: L: R• - rear Building height Bldg Square footage %Open Space: (Lot area minus bldg &paved parking) ,pf `Parking Spaces of Loading Docks Fill: -:(vol-time--& location) "13 . Certification: I hereby certify that the information contained herein _ 4;a. is true and accurate to the best of my knowledge. D211TE: /0 - j,, A C APPLICANT's SIGNATURE NOTE: issuanoe of a zoning permit does not relieve an applioanYs burden to comply with all zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Publio works and other appiioable permit granting authorities. "�" FILE # iq File No. of ull/y44' ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: C-­�� Address: / ��/� -�r. 2 /Jib Telephone: OIL 2. Owner of Property: Address: Telephone: 3. Status of Applicant: Owner Contract Purchaser Lessee Other(explain): 4. Job Location: Parcel Id: Zoning Map#,, —&�- Parcel# District(s):_'&I� (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 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/Variance/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 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/Pb[ON : PROPERTY LOCATION:---/G' C MAP 11-11)0 PARCEL: THIS SECTION FOR-OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM EHLED OUT Fee Pa*d RiTilding Permit Filled apt ld�a Z4 Striyrture c? _ ✓ THF,POLLOWING ACTION HAS BEEN TAR HI N ON TS 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 lPermi 4 Co at' mi Signature of Building Inspect r Datot NOTE: lasuanoe of a zoning permit does not relieve an nppiioant's burden to oomply with all zoning requirements and obtain all required permits from the Board of Health, Conservation Commlealon, Department of Publio Works and other npplioable permit granting authorities. - A CD 00 A � 0rs' CD ° 0 00 CDo BCD o -,_ �'. c Boa A I ° e � A bb In :3, C) ua � ,� gE. aa � � uoi Cr) c. c < n �' �. �� n o rt ao � C) rfDr o n O n ,mod �• � �, c �• S. , � rl w a a- ..�"r ril r• O trQ d Z a 5 c o �� 0 0 p � CD D Lot cn D v� o s s y N rw tz o' o ° O U� :z ,Y, -) = aQ tJ W n ° i?. tj M o a (� o o o o a CD aN d A c o 0 b o � � y 7C' � Off--• /�� • � o O n m �.