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AS A HOMEOWNER I UNDERSTAND YHAT I MAY APPI-Y FOR AND RECEIVE
A BUILDING PERMIT FOR A HOME OR ADDITION I INTEND TO LIVE IN ,
I ALSO UNDERSTAND THAT I AM RESPONSIBLE FOR 1;N0W fNG TF..T STA'T'E:
BUILDING COPE AND ZONING ORDINANCE OF •I•H C' I 'TY OF NORTHAMPTON,
EYEING A,HOROWNER AND NOT A PROFESSIONAL. CONTRACTOR IN NO MAY '
ABSOLVES ME OF ANY RESPONSIBILITY TO INSURE THAT ALL FACFTS-
OF THE RULES AND REGULATIONS ARE COMPLIED HITH ,
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D cit.t T' .lc-.,.(.-,1 1.9.1.0 No .
„OPTING PERMIT APPLICATION
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a m e, oJ., A I.J.ca i i t 2-1-)
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A d d Telephoric.i :
2 Owner o F P c)i-.)o r t y :
A d d.i.-,C�S S P 11
J Status oJ.' AID]'. Ii c a n t : C_--Own e r
____LesISC.0 .__Other (expla ill :
4 . Parcel I'd entifica ti oil : zollilly Map Sheet_//. aal p a r c,�ij 2_7 491
District (s) ( include ov&-rIa- y-s)
Zoning
5 . Proposecl
Use of S-t-.r.,ucturc/Proparty
( i:E projoct iv only interior work, skip to #6)
Building height
.%-Bldg , Cover agcy,
Setbacks :F d.4 -. front
sicle
rcir
Fro n t:ago
Floor Area Ratio
Open Spice (Lot ar ea minus
buildirig and pa.rklng)
Par)cing Spaces
Loading
Signs
ation)
Fill (volume & locc
,'6 ,,..'..Narr_ative Description of Proposed Work/llro�Qct: up, additional sheets
e
ry)
f.,.n e C es S a
' N
7 . Attached Plans : -Sketch Plan Site Plan
B . Ce.rtification : I hereby certify that the information contained herein
is tr"ItD aj)d accurate to the best of my knowledge .
Date : 1 Applicant ' E; Signature:
THIS EUMTTOIT FOR OFFICI-Ali USE 01MY:
/Approved as presented/based on informa •ion J)rosented
—Denied as presented
a s-16n f:of D q -i ia 1.
'11C T115
S rg nii: t u... 11 C T S Inspector Data
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Miscellaneous Additions,Repairs,Alterations,etc. Tel.No.-
GO NORTHAMPTON, MASS. <��=;;.,_19..� Additions
APPLICATION FOR PER IT 1'O ALTER Repair
Garage
1. Location s l- on", ��IErJ �(Jt�- �Y: v re. Lot No.
2. Owners name M,(,l�r r- ` �+ i;`,6�Y\- 4, z_i�vt€'S � Address y,7 Lc)t��y t�� �Y. { �
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
��
4. Addition J� e; k- c�wo k,af—I -77-1 l a r
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
knowledge and belief.
tgnature of responsible applicant
Remarks
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