29-145 (3) PEnRMMIT APPLICATION_CHECK LIS
PAGE / PLOT 7 ZONE �Y ` 7C c 4 YES ' NO t~A*E*
ZONING FORM APPLICATION
2 . PE I P I v
3 . W 0
4 . 3 SETS OF PLANS PLAN
5 . NEW CONSTRUCTION
6 . CURB CUT
7 WATER
8 . REMODELING
9 . ADDITION
10 , ACCESSORY UC
11 . SIGN / AWNING
2 . PERMIT FEE — CHfjQNLY — MONEY I
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABL
14 . UNDER SECTION 2 — C R 780
15 , 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
r
Garage
1.ANIcation /'UC2 1�Yi.GI ✓G /` Orc C _7 !7� Lot No.
2. Owner's name ticr��" / c..a�tl�f r*�~ Address 7 8 _5p7/ace- x5!11 A�=
3. Builder's name ,V(g VE Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition did 7- P40 M e%15'7/.v
5. Alteration A"t��
6. New Porch
7. Is existing building to be demolished? A/L�
8. Repair after the fire
9. Garage 1 / No.of cars Size /
10. Method of hearing .F/o ZZ A/A/tr .9 r7 e* e,4 r .LrL,ee 7� e.4-Ire d am+r
11. Distance to lot lines
12. Type of roof�/A Z c AL
�` r.1 �1 I�
13. Siding house r p c�.�/ �' .ct. -
14. Estimated cost:-
The undersigned certifies that the above statements are true to the best of his, her
Oknowledge and belief.
Signature of responsible app icon!
Remarks
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DEPARTMENT OF BUILDING INSPECTIONS -
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060 y
HOMEOWNER LICENSE E)MMP rION
(Please Print)
DATE: —
JOB LOCATION:
(Ma ) (Parcel) (subdivision)
HOMEOWNER:
(Name- & Address)
o r .vac y/,3- is G-o*,.P7
(Home Phone) (Work Phone)
The current exemption for "homeowners" was extended to include
O� occupied Dwellings of one (1 )or two (2) families, and to allow such .
homeer to engage an individual for hire who does not possess ai
ense, 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 AND SHALL BE ON THE JOB AS SUPERVISOR.
HOMEOWNER SIGNATURE
BUILDING PERMIT #
u
002343
Date Filed ''
File No.
ZONING PERMIT APPLICATION (§10 . 2 )
1 . Name of Applicant:
Address : --p, ,// ��� �- Telephone: .mac?& — L"1 VIP 2
2 . Owner of Property:__. S'fti�,G' , &.
Address : /�-' Telephone :
3 . Status of Applicant: yOwner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# , 7) - ;Parcel# �'
Zoning District (s) (include overlays)
Street Address _ A
Required
5. Existing Proposed by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front 4-
- side L: R: L: L�� R: 3-. f /g
- rear c�li e7
Lot size
Frontage
Floor Area Ratio
. %Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
signs
Fill (volume & location)
6. Narrative Descrim,tion of Proposed Work/Project: (Use additional sheets
if necessary) L?o,,.t,fjr ,, •� e
c+ .
Y r CC
7 . Attached Plans : .� Sketch Plan Site Plan I�
8 . Certification : I hereby certify that the information contained herein
is true and accurate to the best of my knowledge .
Date: `� 1 ? Applicant' s Signature: .
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as presented--Reason:
S 1 cia ' Permi ,end/or Site Plan Required :
g Requ ' r6d j
Varianc4 Required
s.gnatu. e of ildin c or
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 granting authorities.
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