36-143 (4) PERMIT APPLICATION CHECK LIST
PAGE PLOT /" ZONE 'E S NO -DATE.
1 . ZONING FORM APPLICATION
2 . PERMIT APPLICATION
3 . OWNER OCCUPANT STATEMENT LIC .# IF NOT
4 . 3 SETS OF PLANS T PLAN
5 . NEW CONSTRUCTION
6 . CURB CU
7 . WATER AVAILABILITY FORMS
8 . REMODELING INTERIOR
9 . ADDITION
10 . ACCESSORY STRUCTURE
11 . SIG AWNING
12 . PERMI - CHECK ONLY - MONEY ORDER
13 . SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - CMR 780
15 . FORM
16 . FILL
COMMENTS :
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Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. 4lterations
NORTHAMPTON, MASS. 19 .Additions
APPLICATION FOR PERMIT TO ALTER ;repair
Garage
1. Location
�� ./ /� .ot No.
2. Owner's name W111k ( O j4' Address d� ii'Asicle
3. Builder's name 224-1e-f ✓F'//"IGi. j Address
Mass.Construction Supervisor's License No. dl-76 J3 Expiration Date A61,'4/ \
4. Addition
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
f Q
11. Distance to lot lines yQ -�- Q
12. Type of roof
13. Siding house
14. Estimated cost- �o -
The undersigned certifies t the above statemen `true to the best of his, her are
knowledge and belief.
Si aeure ojr ponstble appicant
Remarks
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