29-262 (2) ' A p PERMIT APPLICATION CHECK LIST
PAGE - r PLOT ZONE d� YES NO DATE
1 ZONING EORM APPLICATION
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2 ''` )PLICATIQN
3 .fi. O
4 . 3 SETS OF S
5 . NEW CONSTRUCTION
6 . CURB CUT
7 WATER FORMS
8 . REMODELING
9 . ADDITION-
10 , ACCESSORY STRUCTURE
11 . SIGN / AWNING
2 E - CHECK ONLY -
13 . SPECIAL PERMIT REQUIRED W TH DEED IF APPLICABLE
14 . UNDER SECTION 27 - C R 780
15 . FORM A
16 , FILL
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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. S� 2917 Alterations
NORTHAMPTON, MASS. S// 0 19e Additions
APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location 40N6 VIEW PPV Lot No.
2. Owner's name /J ?,U-963 AOdLc Address ¢� LD',V6 V rtw P? t4-02CwCL-
3. Builder's name oWNGyt-- Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition �� ' X 1Ca i Alc�cK
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 heaung
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost:- p
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.4, ��
Signature of responsible app icant
Remarks
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