17D-018 (2) PERMIT APPLICATION CHECK LIST
PAGE 13N y YES NO DATE
2
3 LIQJ IF NOT
4. 3 S PLAN
NEW CONSTRUCTION
6 CURB CUT
7 WATER S
8. REMODELING
9 . ADDITION
0 . ACCESSORY STRUCT
11 . SIGN ,.
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12 . PERMIT FEE MONEY
13 . SPECIAL PERMIT REQUIRED WITH DEED, IF APPLICABLE
14 . UNDER SECTION 127 — CMR 780
5 . FORM
16 FILL
COMMENTS:
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DEPARTMENT OF BUILDING INSPECTIONS -
INSKCTOR 212 Main Street • Municipal Building 'f
Northampton, Mass, 01060
HOMEOWNER LICENSE MMMPTION
(Please Print)
DATE: I ra j
JOB LOCATION: /_7 D l 6
(Map) parcel) (Subdivision)
HOMEOWNER: S
(Name7g, 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 buildinq
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
BUILDING PERMIT #
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
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Garage
1. Location 9 1 -r2 P,(at) AYe. I�- (o Q_e�v e Lot No.
2. Owner's name Address [`� l ST��L¢L)
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. A
5. Alteration Ovna i
6. New Porch
7. Is existing building to be demolished?_ "/ S
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 cosA—
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
�,. Signafu�e oJresponsb(e appican!
Remarks
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Date Filed `)4 7
File No.
ZONING PERMIT APPLICATION (Si0'.2)
1. Name of Applicant., L e- 7 S
Address: /�/ & Telephone:1 -/D
2 . Owner of Property: . �= lS
Address:. 1 Su 5` r?,Ja(Q,) e- Imo!o IZeNeC Telephone:
3 . Status of Applicant: ✓Owner Contract Purchaser
Lessee Other (explain )
4 . Parcel Identification: Zoning Map Sheet# 0,0 Parcel# 1 '
Zoning District(s) (include ove lays)
Street Address
Required
5. Existinq Proposed by Zoning
Use of Structure/Property
(if project is only interior workpskiVp to #6
Building height
%B1dg. Coverage (Footprint)
Setbacks - front -
- side
- rear
Lot size
Frontage.
Floor Area Ratio
%Open Space (Lot area minus ZZ
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6 . Narrative Description of Proposed Work/Project: (Use additional sheets
if necessary)
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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 knowledge.
Date:. .S/-�/- �J�f Applicant's Signature:
/' THIS SE CTION FOR OFFICIAL USE ONLY:
'V-Approved as presented/based on information presented
Denied as presented--Reason:
Special• Permit and/or Site Plan Required:
ind g Req d: variance Required:
L .
4gnatur i ding In ctor
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply Wdli all zoning requirements and obtain all required permits
from the Board of Health,Conservation commission, Department of Public Works and other applicable permit granting authorities.
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City of Northampton REQUIRED INSPECTIONS
UII �DING DEPARTMENT 1. Footings and Walls
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� � 2. Structural Components in Place
3. Complete Building*
No. 290 Office of the Building Inspector
Zoning Form No. 002478 Date 4/27/94 Fee 10 Check# 5715
Page, 17D Parcel 18 Zone URB Section 127 ❑ Yes No
BUI]LDINGPERMI r I I
* Plumbing and Electrical Inspections required
THIS CERTIFIES THAT FngPna ni hr;G before Building Inspections
has permission to Demolish garage - no existing hook-ups Inspection on Site—Foundations
situated on 121 Straw Ave. 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 Manufacturers information: windows, vinyl siding,
roofs and woodstoves. Smoke Detectors(Fire Department)
Other
F
THIS CARD MUST BE DISPLAYED IN A CONSPICU U PL N THE PREMISES
Certificate of Occupancy --
gInspector IMF