17C-302 (2) 10. Do any signs exist on the property? YES NO
IF YES,describe size, type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NOGG
IF YES, describe size, type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This colamn to be filled in
by the Bnildiag Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks -
- side L: ASR: },?,r ,_ f—R. ,
- rear
-!
Building height ,
Bldg Square footage �`r
��o� /
_ c,
2-9 >
%Open Space:
(Lot area minus bldg
&paved parking)
L a
#, ?f -Parking Spaces
#- of Loading Docks
Fill:
(volume -& location)
13 . Certification: I hereby certify that the information contained herein
rf is true and accurate to the best of my knowledge.
DATE:,3/& APPLICANT's ,SIGNATURE '
NOTE: I"s anoe of a zoning permit does not relieve an applicant's r en to comp with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applicable permit granting authorities.
FILE #
R 1996
File No..
ZONING PERMIT APPLICATION (§10 . 2)
PLEI ASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:.��11//��- �T'/Ut�1//1✓
Address. � 1�ff `S /1J Telephone:�f
2. Owner of Property: __, '`'
Address: Telephone: r'
3. Status of Applicant: !•-"' Owner Contra Purchaser Lessee
Other(explain):
4. Street Address: S/��fl�_�� -—/� �✓���y.Zr t"
Parcel Id: Zoning Map# Parcel# !%J District(s):_ �
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
7. Attached Plans: Sketch Plan _p- Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO v-' DON'T KNOW YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO—V--"' DON'T KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained ,date issued:
(FORM CONTINUES ON OTHER SIDE)
�t l
�a��,
� a Crzt� .�f �>rz�}�ant�fIIrr
� e 1
�tasnyau. _
DEPARTMENT OP BUILDFNG INSPECTIONS
INSPECTOP 212 Main Strcct ' Municipal Building
Northampton, Macs. 01060
HOMEOWNER LICENSE EXEMPTION
DATE_
/ (Please Print)
,3/�,.��( _-
JOB LOCATION- ! ( t G �' / �✓
Map), (Farce / (Subdivision)
HOMEOWNER: �3e�- ��/ '! V
(Name & A dress )
( Home Phone ) (work Phone )
The current exemption for "homeowners" was extended to include
Owner-occupied Dwellings 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 homeo%rner . 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 recruired 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 bed 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 ##
7
` 96070'7
FILE #
APPLICANT/CONTACT PERSON: -
ADDRESS/PHONE:
r
PROPERTY LOCATION: -
MAP C' PARCEL:
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Fee paod
Rivilding Permit Filled apt
T (-'-A
'Remodeling T
Addition to Ryktinn2 (/�_.
Plan's 412-j—ja—L"�Elan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
A proved as presented based on information presented
enied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received &Recorded at Registry of Deeds Proof Enclosed_
X Finding Required under:§�_w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
ariance Required under: § �/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
Pern L it from Co ervation C ission
Signature of Building Inspector Date
NOTE:Issuanoe of a zoning permit does not relieve an applloants burden to oomply with ail
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Public), Works and other applioable permit granting authorities.