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` DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
HOMEOWNER LICENSE EXEMPTION
(Please Print)
DATE:
JOB LOCATION:
L.
(Map) (Marcel) (Subdivision)
HOMEOWNER: _6AIA14 L. ZA L UGfLI l,SY Jq nJ 1210 N U2i W&z'»/ r6 J
(Name & Address)
5-8-6 -
(Home Phone) (Work Phone)
The current exemption for "homeowners" 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 does not possess at
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 AND SHALL BE ON THE JOB AS SUPERVISOR.
HOMEOWNER SIGNATURE
BUILDING PERMIT # C: 1/
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Miscellaneous Additions,Repairs,Alterations,etc.
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NORTHAMPTON, MASS.
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Zoning
Alterations
19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location '51 Lot No.
2. Owner's name AA n,2 /u ctu' Address R rd n n�
3. Builder's name t// Address Al
Mass.Construction Supervisor's License No. Expiration Date
4. Addition NPR fr.e).1-t-- sfa r+_� jn +e e)" eYoor-
5. Alteration &C/oSi nc 5ereen Born:— jhh) Cae-o ce
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
14. Estimated costal t�L- / 0 o
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The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
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Signa,Wof responsible app, cant
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Tel.No.
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Zoning
Alterations
19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location '51 Lot No.
2. Owner's name AA n,2 /u ctu' Address R rd n n�
3. Builder's name t// Address Al
Mass.Construction Supervisor's License No. Expiration Date
4. Addition NPR fr.e).1-t-- sfa r+_� jn +e e)" eYoor-
5. Alteration &C/oSi nc 5ereen Born:— jhh) Cae-o ce
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
14. Estimated costal t�L- / 0 o
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The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
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Signa,Wof responsible app, cant
in
n,,-Avw17 003363
Date Filed ` \ �
%-��-9�/ File No.
Z014ING PERMIT APPLICATION (510'. 2)
1 . Name of Applicant: ANNA G 2AL
Address: g /IJp. fhan-r Telephone:
2 . Owner of Property: SRE'1?c
4) S3Z
Address : - Telephone:
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain
4 . Parcel Identification: Zoning r
Zoning District(s) (include ov"lays)
Street Address -
5.
Use of Structure/Property
(if project is only interior work, skip
Building height
%B1dg . Coverage (Footprint)
Setbacks - front
side L: R:
rear
Lot size
Frontage.
Floor Area Ratio
%Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & locatio
Sheet` 1A
Proposed
to #6)
L:
a r c e 1 �a ,
Require
by Zoni
6. Narrative Description of Proposed Work/Project: (Use additional sheets
if necessary) a
0
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7 . Attached Plans: Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowled e.
Date: L% -,� -g y Applicant's Signatur
^,
V/Approved THIS SECTION FOR OFFICIAL USE ONLY:
V Approved as presented/based on
Denied as presented--Reason:
ecial•' Per _ It and/or Site Pl
/Gn n9 q5 rid:
information presented
n xequireci:
Variance Requir
a �1
l �gna of Building Inspector D G to 5
NOTE: Issuance of a ionfng permit does not relieve an applicant's burden to comply witli all zoning requirements and obtain aU required permits
from the Board of Health, Conservation Commission, Department of Public Works and other applicable permit granting authorities.
101-
PERMIT APPLICATION CHECK LIST
PAGE r�g PLOT �a ZONE �� YFS Nn nATF
Atf 41A. pAt,),- 4"ff"OtL L ppFAr Pe�(,t i56
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ZONING 0 LIC IO
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2 .
PE MI -I
3 . -
OW O
3 SETS PLAN
NEW CONSTRUCTION
6
CURB CUT
7
WATER
8 .
REMODELTNG
9 .
ADDITION
0 .
ACCESSORY STRUCTURE
11 .
SIGN / AWNING
2 ,
PERMIT FEE - C - MONEY ORDER doh
13 .
SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
4 .
UNDER SECTION 127 - C R 780
15 ,
FORMA
6 .
FILL
COMMENTS:
Atf 41A. pAt,),- 4"ff"OtL L ppFAr Pe�(,t i56
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City of Northampton REQUIRED INSPECTIONS
e BUILDING DEPARTMENT 2. Struccttugral and Walls
Components in Place*~
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3. Complete Building*
No.
971 Office of the Building Inspector
,
Zoning Form No. 003368 Date 9/22/94 Fee 40 Check# 1101
Page, 28 Parcel 32 ,Zone SR Section 127 ❑ Yes No
BUI]LDINGPERAM
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Anna Zalucki before Building Inspections
has permission to Repair porch supports and replace front steps Inspection on Site—Foundations
situated on 658 Ryan Road 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—Finish
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 PLA=ON PREMISES
Certificate of Occupancy ;_7'z_�
Building Inspectru ��—r
1._1;1!Sit�1