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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060 v,`
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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. '✓1��� Alterations V
so NORTHAMPTON, MASS. 19A Additions
Repair
ALICATION FOR PERMIT TO ALTER Garage
1. Location r�,�pp Lot No.
2. Owners name 4 � Address � �✓»(_ 2
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
s
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
11. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost:
The undersigned certifies that the above statements are true to the best of his, her
knowl dge an d belief.
Signature of responsible applicant
Remarks
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