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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
a
Garage
1. Location 9S 7\04bUA Ui trt�� Lot No.
2. Owner's name CAz-m eb -* ka-±�'PQ,li1 (-�SZ-; Address�yY1e-
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition Y-4o
5. Alteration — mnl�1 ace V%kn".01
6. New Porch Vvb
7. Is existing building to be demolished? VLo
8. Repair after the fire we
9. Garage r t No.of cars Size
10. Method of heating do
11. Distance to lot lines
12. Type of roof vkd
13. Siding house Y'lb
14. Estimated cost- �'LO�•
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
i responsible app,ican!
Remarks
9
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DEPARTMENT OF BUILDWG INSPECTIONS —
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060 v
HOMEOWNER LICENSE EXEMPTION
_ (Please Print)
DATE: � ���S� 9 5 _
JOB LOCATION: C61)(parcel) (subdivision)
HOMEOWNER: ��z v 4 es; Z 9 S bU N P4kI h�oYt x�4 is ry�Q
( me- & Address)
58� IZ 6L-k �—`i Fs• �'s119
(Home Phone) (Work Phone)
The current exemption for "homeowners" was extended to include
_Owner-occupied Dwellings -of one (1 )or two (2) fami 1 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 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 persons) 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
��iAND SHALL BE ON THE JOB AS SUPERVISOR.
HOMEOWNER SIGNATURE �.�y akLLO S2_
BUILDING PERMIT #
9
10. Do any signs exist on the property? YES NO N x
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 cols tro be filled in '
by the 8aildi.ng Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- 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:
. .(volume & location)
i
13 . Certification: I hereby certify that the -information contained herein
is true and accurate to the best of my knowledg
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DATE: s '4s,q� APPLICANT'S SIGNATURE - s'LZ
NOTE: Issuanoe of a zoning permit does not relieve an applioanVe b rden to o4 imply with all
zoning requirements and obtain all required permits from the Board of Health j'Cpnservation
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE #
. ... .. -....... .. ... ......,..:1...a+....... ..:_✓...:{ Rte' M":��_.._ ..-:: .:-....,....�vs.:..�.��... �
SEP
File No. DEPT RT t3F f kQ!NG INSP£CTibf
NOH...... QN 010&0 JS
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: dV�1�D S
Address: Telephone:
2. Owner of Property: S5ayA'9_
Address: 52 W13.- Telephone:
3. Status of Applicant: y Owner Contract Purchaser Lessee
Other(explain):
4. Street Address: S52 NYKQ_
Parcel Id: Zoning Map# � Parcel# / District(s): 41-1Z1
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property YY%, _Q__
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 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 DONT 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 # 960214
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE:
PROPERTY LOCATION:
MAP PARCEL: ZONE Gr
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
11stilding Prrmit MUM nut
IDI
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS 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
it from C s atio ommission
ature of ' — _ ate
NOTE:Issunnoe of a zoning permit does not relieve an appiioant's burden to oomply with all
_ zoning requirements and obtain nil required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioabie permit granting authoritles.
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