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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building '�V
Northampton, Maas. OIOGO
HOMEOWNER LICENSE EXE-b 1'I0N
DATE:
/ ' (Please Print)
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JOB LOCATION:
(M ) (paresla (Subdivisi )
HOMEOWNER. ii�1 IZ fL ��� ���:, ► } t-� l C� � x
( ame & Address)
( Home Phone ) (Work Phone )
The current exemption for "homeowners" was extended to include
Owner-occupied Dwellings of one ( 1 )or two (2) fami I 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 . Ch1R780 Section 109 . 1 . 1
DEFINITION OF HOI�1EOWNER: 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 Buildina
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
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