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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 CIYr r�t'e?f�� r, iCL1L`PiL' Lot No.
2. Owner's name al6zg�r Address
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition fG /�5. i,�sa��� ,�'��o c Zi
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:- ly,600,CIO
The undersigned certifies that the above statements are true to the best of his. her
knowledge and belief.
Signature of responsible pp—ant
Remarks
0
g a C_'f of ort1 "' fo1Y
e APR 2 81997 �' _
Be°� AIsa(l)uoCIts _
vP , r;t,IEPARTMENT OP BUILDING INSPECTIONS
INSPECTOR _ _. ......�.. " 212 hfnin Strcct ' Municipal Building
Northampton, Mass. 01060
HOMEOWNER LICENSE EXEMPTION
( Please Print )
DATE:
JOB LOCATION:
(Map) ( Parcel ) ( Subdivision)
HOMEOWNER:
( Name & Address )
?
if
( Home Phone (tgork Phone
The current exemption for "homeowners" was extended to include
Owner-occupied Dwellings of one ( 1 )or ts•m (2) farm 1 ies and to allow suc
homeowner to engage an individual for hire who does not possess
license , provided that the owner acts as supervisor . CMR7B0 Section 109.
DEFINITION OF HOMEOWNER: Person( s ) who own a parcel of land o:
which he/she resides or intends to reside , on which there is , or i.
intended to be , a one or two family dwelling , attached or detache,
structures accessory to such use and/or farm structures . A person wh
constructs more than one home in a two-year period shall not b
considered a homeowner . Such "homeowner" shall submit to the Buildin
Official , on a form acceptable to the Building Official, that he/sh
shall be responsible for all such work performed under the buildin
permit .
As acting Construction Supervisor your presence on the job sit
will be required from time to time , during and upon completion of th
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 fc
injuries not resulting in Death) of the Massachusetts General La%-,
Annotated , you ma be liable for person ( s ) you hire to perform work fc
you under this permit .
The undersigned "homeowner" certifies and assumes responsibili ',
for compliance with the State Building Code , City of Northamptc
Ordinances , State and Local Zoning Laws , and State of Massachusett
General Laws Annotated .
HOMEOWNER SIGNATURE
BUILDING PERMIT #
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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 colma to be filled in
by the Baildiay Department
Required
Existing Proposed By Zoning
Lot size
Frontage 0 C) C� J C v
Setbacks so 5J4
- side L: R: C LA J(,kR: &3`�,
- rear
Building height 7�
Bldg Square footage
%Open Space:
(Lot area minus bldg 'Id
' &paved parking)
of -Parking Spaces
f %f Loading Docks
Fill:
Avol-ume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
_1
DME: 61,E 129 7 APPLICANT's SIGNATURE
NOTE: Isaiumnoa of a zoning permit does not relieve an applioant's burden to oom
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other appiiooble permit granting authorities.
FILE #
.ra
x
F
- File No.
9U 7.3
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: / �!",;�,-�r�,�nf�%' ��r Telephone: Wit?s'�
2. Owner of Property: %���� �;-y.;�f✓ ir?rl�,-5 c1ir ,�✓ �T
Address: /Le �i�.,-;n/� ��r Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain): D�
4. Job Location:
Parcel Id: Zoning Map# Parcel#_ District(s): Z-
(TO BE FILLED IN BY THE BUILDINGii DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed UseMlork/Project/Occupation: (Use additional sheets if necessary):
,4 L?Acf r 1A/ S i aS��?K' OC)X-/ Z�7 4,S i��/'t1 i�_'_
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 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 x 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)
3
3�0
FILE
962 '7
#
I APPLICt N'T�CONTACT PERSON:
�.T, FDRE`5�/PIONE:
PROPERTY LOCATION: 416 (.%/'." '�
MAP PARCEL: 1,9 ZONE_t,/ ?�
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FIT.TFY) OUT
Fee Pnid
lRiii1ding Permit Filled 011t
✓�--
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l
Accessory StrTirtiire
FOLLOWING 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 Conservad ommission
J�L
Signature of Building h
Et-o r Date
NOTE:Issuanoa of a zoning permit does not relieve an applioanta burden to oompty with all
--ning requirements and obtain call required permits from the Board of Health, Conservation
imisalon, Department of Publlo Works and other applloabie permit granting authoritles.
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