35-116 (2) PERMIT APPLICATION CHEC LIST
YES NO DATE
3 . OWNER OCCUPANT STATEMENT iF NOT
4 . 3 SETS OF PLANS
5 . NEW CONSTRUCTION
6 . CURB CUT
7 . WATER AVAILABILITY FORMS
8 . REMODELING INTERIOR
9 . ADDITION
10 , ACCESSORY STRUCTURE
11 . SIG AWNING
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12 , PERMIT FEE MONEY O DER
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - CMR 780
15 . FORM
16 . FILL
COMMENTS : --
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 19 Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
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1 Location o� Co DrC W-O k) ►r. f t0rC ACI Lot No.
2 W BuiOwner's name Address C S,4
3
lder's name Address
(N ass.Construction Supervisor's License No 1610 7 1 Expiration Date
4. Addition
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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
Siding house
4�, Estimated cost
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signal of responsible app,ican!
Remarks
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