36-102 (2) a
T ^►
cDi�
z n
z
7t7 c
� o
Z _•
fx, R r11
-s
Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.5 9 y 166)_l Alterations
NORTHAMPTON, MASS. /7 '$ 19 6, Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location q 5 S 3 ca r is Lot No.
2. Owner's namW t I I 1 a m H C ],?W 1 o Yl Address sa
t-
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Almmtian �O'-a 9 h P-A x
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 cosL-
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
$ azure of responsible app.lcani
Remarks
�O � O�
3 8 ��� U'f �17Zfh&111�1�UTT
; 8 llicsrRC}lutrdr
Q "
DEPAATMENT OP BUILDING INSPECTIONS
INSPECTOR 212 Main Strcct ' Municipal Building
Northampton, Macs. 01060
HOMEOWNER LICENSE EY2-HPTION
1 _ r (Please Print)
DATE: 7 co
JOB LOCATION : +�� r e 5 �`''
(Map) _ (parcel ) ( Subdivision )
HOMEOWNER: W
(Name ddress }
5$ r �, ic� F�l��e,�c� 52, i �lnl rl
( Horse Phone ) (Work Phone )
The current exemption for "homeowners" was extended to include
Owner-occupied I7we11inGs o_ one ( ] )or two (2) >=ami 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 . C1]R780 Section 109 . 1 . ]
DEFINITION OF Person( s ) who own a oarce 1 or land on
which he/she resides or intends to reside , on there is , or 2. s
intended to be , a one or two family dwelling, attached or detached
structures accessory to such use and/or farm structures . .4 person who
constructs more than one home in a two-year period shad not be
considered a homeowner Such "homeowner" shall submit to the Building
Official , on a form acceptable to the Building 0=-icial , 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
r General Laws Annotated AND SHALL BE ON THE JOB AS SUPERVISOR.
{ HOMEOWNER SIGNATU E W&x-,, 1•} 4✓y �.
BUILDING PERMIT
NEW
. � .
~ � ���
� '`w;
'__-_-_______--__-___________--__________-_ ���-_--________--_'__-_'
-
t
10. Do any signs exist on the property? YES NO
IF YES,describe size,type and location:
, t
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 MAST BE COMPLETED, or PERMIT CAN BE DENIED DUE To
LACK OF INFORMATION.
This colx � to be filled in
by the Building Departament
Required
Existing Proposed By Zoning
Lot size
830
Frontage
Setbacks
- side L: R: L: R:
- rear /
Building height
Bldg Square footage
%Open Space:
'(Lot area minus bldg
' &paved parking)
# of -Parking Spaces
#
of Loading Docks
Fill:
':(vol-dme--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DAVE: >( APPLICANT'S SIGNATURE yt
NOTE: Issuano of a zoning permit does not relieve an applicant's burden t mply with all
zoning requirements and obtain all required permits from the Board of Healt , Conservation
Commission, Department of Public Works and other applicable permit granting authorities.
"' FILE #
File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE, OR PRINT ALL INFORMATION
1. Name of Applicant: /,, lam? �k 1 t a M k C i a SSA-�nV-1
Address: /1 95 5 V v i�S _iee` i \\
G Telephone: K
2. Owner of Property:
Address: ?E-S- RT.S �i% Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: `ASS &R%.s
Parcel Id: Zoning Map#- Parcel# /O Z District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
S. Existing Use of Structure/Property tri/JFivC�`
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
/1'Sl4e-L 3�e�fI6 S%5`E� .12—X�K�
7. Attached Plans: - Y\N 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 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 # n U 1 0 3
._ 'J_ l�
APPLICANT/CONTACT PERSON:_,!., -e� ,4l '(,_._
ADDRESS/PHONE:
PROPERTY LOCATION:
MAP (r _ PARCEL:_Z4;2! ZdRE_
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Fee Paid
Ryiilding Permit Filled mit,
New CnnqtrTTrt nn
.lRemndeling Interior
THE 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 Conservation missi n
-
Signature S-
of Building Insp r Date `
NOTE:Issuance of a zoning permit does not relieve an applioanYs burden to oomply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commisslon, Department of Publio Works and other applioabie permit granting authorities.
rJ .,Wow
n •iF 7 +W ti,
O M O< C OJ
, p O
n ►� �'�.m�
cn C4
r� A . O O cc6
ors•
v p to
OR
o � � 0st ,J ^
m In
c r7 (t Q) t�
0 -< m !�
0 o m
o
d
5C � F000� �
Ln
m000d
CA s , Ago
n � �
a
~d 5 C o
CD
l 1 rm o O O o o rte' I
On
a Z C7 c. a a. : 5: Cr
o c 5
On TO O
cL
�° ►.b o ao ac o ao c c cn °o d
ljJ
0-.4
C/1
Ell 5' O
b �