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PERMIT APPLICATION CHECK LIST
PAGE a5C PLOT 04�; ZONE UR 117 �Ccoclb'cne, Ave- YES NO DATE
1 . ZONING FORM APPLICATION 9 �--
2 . PERMIT APPLICATION
3 . OWNER OCCUPANT STATEMENT LIC A IF NOT !/
4 . 3 SETS OF PLANS PLOT PL C; Lc A.
5 . NEW CONSTRUCTION
6 . CURB CUT
WATER 7 .
8 . REMODELING INTERIOR
9 . ADDITION
10 . ACCESSORY STRUCTURE
11 . SIG AWNING
2 PERMI FE - CHECK ONLY - MONEY ORDER 0 '10. o o k-
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - CMR 780
15 . FORM A
i
16 . FILL _ /
COMMENTS : GEC
Va'-n - Sao r a G F' She c1
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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
HOMEOWNER LICENSE EXEMPTION
DATE• ��✓ .�. y�� JL,
(Please Print)
JOB LOCATION: G q,5'
(Map) -(Parcel) (Subdivision)
HOMEOWNER: J '1J)
`r V(Name & Address ) ,SV
(Home Phone) (Work Phone )
The current exemption for "homeowner,s" .was extended to include
Owner-occupied Dwellings_ of one ( 1 ) or two (2) families and to allow such
homeowner to engage an individual for hire who doeG 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 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.
HOMEOWNER SIGNATURE
BUILDING PERMIT #
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
4
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 17 /,)i;t:'e Lot No.
2. Owner's name At,I,-/hT C A t t rc kL Address % 7 Zl-�1.'461d vu e,
3. Builder's name Address "s q r' (n
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished?
8. Repair after the fire
S crrqye'
9. T -- rl1 o.�f�' �r 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 belief.
v
Signature of responsi !e appeican!
Remarks
maw. •r
Date Filed / O - 4 - 9 �� File No. 1'*_5C.- o4S
ZONING PERMIT APPLICATION (§10 .2) a e B
1 . Name of Applicant: �'ali T C�?ai-C- 42
Address : P dcle Telephone:
2 . Owner of Property:
Address : Telephone:
3 . Status of Applicant: X Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# ,6'G Parcel#
Zoning District(s) (include overlays) (� t3
Street Address f•7 Wc3nA biYlP,ayP
Required
g , Existing' Proposed bv Zonin
Use of Structure/Property
(if project is only interior tSork, skip to #6)
Building height
%B1dg. Covera5e (Footprint)
Setbacks /00 - front 161
- side 3' s� L R
- rear _
Lot size - �
Frontage
Floor Area Ratio
%Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6 . Narrative Description of Proposed Work/Project: (Use additional sheets
if necessary) I&;719// ,- oal C/v /S71
Atlllelle& - iLl cr/L l
/7
s Fv r �? T rr?�e -5h cd o-
7 . �
Attached Pans : _Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowled
Date: /'0 - s" - y,.)-- Applicant ' s Signature: ZL,� �
THIS SECTION FOR OFFICIAL USE ONLY: - T - - T
ZApproved as presented/based on information presented OCT 6
De ied as presented
a for al :
/D - F -�z
ignatu of Buildi Spector Date
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.
7/92 FXAS
City of Northampton REQuMED INsPECUONS
�= e
BUILDING DEPARTMENT 2. Struccttural and Components in Place*
e
3. Complete Building*
No. 654 Office of the Building Inspector
Zoning Form No. 000354 Date 10/19/92Fee $20 Check# 2303
Page, 25C Parcel 45 ,Zone URB Section 127 ❑ Yes 0 No
BUI]LDING PERM ir-1
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Dwight Church before Building Inspections
Install dry box van on existing foundation
has permission to for use as a storage shed Inspection on Site--Foundations
situated on 17 Woodbine Ave. Inspection of Plumbing—Rough
provided that the person accepting this permit shall in every respect Inspection of Plumbing—Finish
conform to the terms of the application on file in this office,and to the Gas Inspection
provisions of the Statutes and the Ordinances relating to the Construction, Inspection of Wiring—Rough
Maintenance and Inspection of Buildings in the City of Northampton.
Any violation of any of the terms above noted is an immediate revocation Inspection of Wiring—Fuish
of this permit.Expires six months from date of issuance,if not started. Building Inspection—Rough
Note:A certificate of occupancy will be issued by this office upon return Insulation Inspection
of this card signed by the Plumbing,Wiring and Building Inspectors.
Building Inspection—Finish
Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICU . US. LA THE PREMISES
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Ce4}tificate of Occupancy
Building Inspector
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