29-410 (4) o�tuaiAro �_
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m DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building
Northampton, Mass. 01060
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.HOMErOWlNER 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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Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.S ��S 3 Z. Alterations VO
at TOti NORTHAMPTON, MASS. 7 - 11 19 Additions IV 63
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APPLICATION FOR PERMIT TO ALTER Repair
// Garage AIQ
1. Location D S S !(/� Y �i'f- Lot No.
2. Owner's name If--6)— s S /,F 2 Address /o s sA1/7 y
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration
6. New Porch
7. Is existing building to be demolished? d
8. Repair after the fire y
9. Garage No.of cars Size
10. Method of heating �� �`fl-T
11. Distance to lot lines
12. Type of roof 522)416 l f-5
13. Siding house
14. Estimated cost:-
yThe undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
e. :/l-r 13 (4-- ignature of responsible applicant
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