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Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. - �—9Q gn Alterations
so NORTHAMPTON, MASS. Lam- 19 < �-f Additions
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APPLICATION FOR P R:MIT TO ALTER p
1 Garage
1. Location 61 OUTAI' 00� �/ �//'1 V''e_ Lot No.
2. Owner's nn
sname k-eo /`tldjal _- Address
3. Builder's name '�L i� J'a-V Address t Fr/ ►^ 14
Mass.Construction Supervisor's License No. Q Expiration Date
4. Addition &t X g I
5. Alteration
6. New Porch
7. Is existing building to be demolished? Al 0
8. Repair after the fire
9. Garage No.of cars Size
1.0. Method of heating
11. Distance to lot lines-
12. Type of roof -5 1 r �'
13. Siding house
14. Estimated cost:- S� ,
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
(� Signature of responsible applicant
Remarks Q A ry �A- 1NYL.lJ�P Z�YY
PR YNT±
, _ SHOP
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