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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building '
Northampton, Mass. 01060 V
HOMEOWNER LICENSE EXEMP'T'ION
(Please Print)
DATE:
JOB LOCATIO : r
(Map) rcel) Subdiv' ion)
HOMEOWNER: ::
(Name & Address)
(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 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 41itate of Massachusetts
General Laws Annotated AND SHAL BE ON THN JOB_A5 SUPERVISOR.
HOMEOWNER SIGNATURE C
BUILDING PERMIT #
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� b�toC k Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. >< � Alterations
NORTHAMPTON, MASS. ���� l 19��/ Additions
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APPLICATION FOR PERMIT TO ALTER Repair
�-p Garage
1. q1 Lot No.
2. Owner's name M U Address
3. Builder's name Address
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
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-
J The undersigned certifies that the a ve statements are true to the best of his, her
knowledge and belie .
Signature of sponsible appicant
Remarks
k
Date Filed. File No.
ZO ING PERMIT APPLICATION
I . Name of Ap c
Address: Telephone: -
2 . Owner of Propert ,
Address: Telephone:
3 . Status of Applicant: klOwner Contract Purchaser
Lessee Other (explain )
4 . Parcel Identification: Zoning Map Sheet# Parcel#
Zoning District(s) (include overt s) (0 It-
Street Address
'-
Required
5 .
ExistincT. Proposed -by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
oB1dg. 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 Descr' t ' if Proposed Wo k/Project• (Us additi nal sheets
if necessary) c1
Y
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 know dge.-
F
Date: Applicant's Signature:
/ THIS SECTION FOR OFFICIAL USE ONLY
Approved as presented/based on information presented
Denied as presented--Reason:
Special' Permit and/or Site Plan Required:
d g q ire Variance Required:
gnatur guilding or e
NOTE: Issvanco of a zoning permit does not rellove an applicant's burden to comply Wilt all zoning roquiroments and obtain all requirod pormHs
from tho Board of HoaltN Conservation Commission, Dopaitmont of Public Works and othor appiicablo permit granting nuthoritlos.
PERMIT APPLICATION CHECK LIST
PAGE /rZ' -PLOT ZONE 17 ' NO DATE
ZONING 0 IO
2 . PERMIT I
3 . Ow
_"UPANT STATEMENT
3 SETS OF PLANS /PLOT UAN
5 . NEW . CONSTRUCTION
6 CURB OUT
WATER
8 . REMODELI
9 . ADDITION
o . ACCESSORY
11 . SI -
2 E - -
3 . SPECIAL I APP ICABLE
4 , UNDER E - CMR 780
5 FORM A
16 FILL
COMMENTS ,
Cit y of Northampton REQUIRED INSPECTIONS '
DEPARTM ENT 1. Footings and Walls
BUILDING 2. Structural Components in Place*
3. Complete Building*
No. 494 Office of the Building Inspector
Zoning Form No. 004423
Date 6/16/95 Fee $20 Check# Money Order
Page, 17A Parcel 126, Zone URA Section 127 ❑Yes ®No
BUI]LDING PERMIT
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT Amy Jo Sullivan before Building Inspections
has permission to Install siding & reshingle roof Inspection on Site—Foundations
situated on 297 Bridge 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
** Install per Manufacturer's information: windows,vinyl siding, roofs Smoke Detectors (Fire Department)
and woodstoves
Other
THIS CARD MUST BE DISPLAYED IN A CONVICC PL N THE PREMISES
Certificate of Occupancy
Building Inspe or