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DEPARTMENT OF BUILDING INSPECTIONS �
INSPECTOR 212 Main Street ' Municipal Building '
Northampton, Mass. 01060 "
HOMEOWNER LICENSE EX[EM TION
(Please Print)
DATE;
JOB LOCATION: HL 9
(Map) (Parcel) (Subdivision)
HOMEOWNER: S,4 sew Pa r,rel1
(Name & Address)
Hs rQ" st L - �- s fgy_ y27D
(Home Phone) (Work Phone)
The current exemption for "homeowners" was extended to include
Owner-occupied Dwellincxs 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 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 C1av►�1 /r �, 1`�/1(�LJ �
BUILDING PERMIT # "
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. �v Alterations
NORTHAMPTON, MASS. 8� 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location i Lot No. c� 3
2. Owners name (7) n` : f AWJQA I S:1sfto ' rre Address 9 HE ERNgN 5t C,EEDS
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition IL 4
5. Alteration Avy
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 r I raR,�j Ass $h ,a l R E - (Z va� )
13. Siding house
14. Estimated cost:- � ) q 00`)0
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Qk-,�-A ram
Signature ojresponsible appicane
Remarks
003158
Date Filed `
File No.
ZONING PERMIT APPLICATION (§10 . 2)
I . Name of Applicant: Susrjrj r4rr'e 1/
Address : T Nt � Sf L6e0s Telephone: s5sy- `1a9b
2 . Owner of Property:_ jgrrEll /ya171elh,9
Address : N(i rl"elephone:
3 . Status of Applicant:--4Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map
Sh t# Parcel#
Zoning District(s) (include ov lays)
Street Address r 3
,
Required
5 . Existinq Proposed b onin
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
- side L: R: 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 Descri tion of Proposed Work/Project: (Use additional sheets
if necessary)
va
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 knowledge.
Date: l s� Applicant's Signature:_ S„ Q0111 �7am,
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as presented--Reason:
1�,Wr;cial* P it and/or Site Plan Required:
In e ed: Variance/Required,
4scg e of i.ng Inspector D e
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning toquiraments and obtain all required permits
from the Board of Health, Conservation commission, Department of Public Works and other applicable permit granting authorities.
it'71-
FACE `� G PLOT a 3 ZONE YES NO DATE
1 . ZONING FORM APPLICATION ---j��
2 PERMIT APPLICATION
3 . OWNER OCCUP N ST T ME
4 3 SETS OF PLANS /PLOT
5 NEW CONSTRUCTION -- --
6 . CURB CUT
7 . WATER AVAILABILITY FORMS
8 . REMODELING INTERIOR
9 . ADDITIO
10 . ACCESSORY STRUCTURE
11 . SIGN / AWNI
12 , PERMIT FEE - CHECK ONLY- - MONEY ORDER
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13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - CMR 760
15 . FORM A
16 . FILL
COMMENTS :
C it of Northampton REQUIRED INSPECTIONS
1. Footings and Walls
BUILDING DEPARTMENT
a � 2. Structural Components in Place*
3. Complete Building*
No. 825 Office of the Building Inspector
Zoning Form No. 003158 Date 8/24/94 Fee $20 Check# 0681
Page, 11C Parcel 23 Zone URA Section 127 ❑ Yes ® No
BUI]LDINGPERMI r I I
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Susan Farrell before Building Inspections
has permission to Strip & reshingle roof Inspection on Site—Foundations
situated on 9 Heffernan Street 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.
** Install per Manufacturers information: windows, vinyl siding, Building Inspection—Finish
roofs and woodstoves. Smoke Detectors(Fire Department)
Other
THIS CARD MUST BE DISPLAYED IN A CONSPICUOUS PLACE ON THE PREMISES
Certificate of Occupancy —
Building Ins
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