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�A55ACI�1T6lt�H �
DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building '
Northampton, Mass. 01000
AS A HOMEOWNER I UNDERSTAND THAT I MAY APPLY FOR AND RECEIVE
A BUILDING PERMIT FOR A HOME OR ADDITION I INTEND TO LIVE IN.
I ALSO UNDERSTAND THAT I AM RESPONSIBLE FOR KNOWING THE STATE
BUILDING CODE AND ZONING ORDINANCE OF THE CITY OF NORTHAMPTON.
BEING A HOMEOWNER AND NOT A PROFESSIONAL CONTRACTOR IN NO WAY
ABSOLVES ME OF ANY RESPONSIBILITY TO INSURE THAT ALL FACETS
OF THE RULES AND REGULATIONS ARE COMPLIED WITH.
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. �k b ���^S/ Alterations
so NORTHAMPTON, MASS. -� 19 Additions
Repair
APPLICATION FOR PERMIT TO ALTER
Garage /
1. Location 2 TO L jG q +(L -- t-A). W D44W{ ?TV&) Lot No. 6
2. Owner's name S-Au H— Ce,,�( O6, Address'Z-( 1 1�-�-
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition 06
5. Alteration �J 17��51PiAA e— ,jr 5 :jJt k-14TCKeII)
6. New Porch �l f
7. Is existing building to be demolished? j
8. Repair after the fire Al 10
9. Garage No.of cars Size
10. Method of heating 1 4 C,
11. Distance to lot lines 2� +
12. Type of roof `J{ `� 1 � � ( S flO•�u�
13. Siding houseCt (�►t
14. Estimated cost:- �Z 0) �d
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief. )
Signature of responsible applicant
Remarks
PH,IN, _TnSHOP
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