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Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. Alterations
NORTHAMPTON, MASS. 4— 2-e, 19T/ Additions
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e APPLICATION FOR PERMIT TO ALTER Repair
Garage
1. Location ag C� �u-aa �Q�zQ,iZ Lot No.
2. Owner`s name Address aaot 'Z AWL tN\s, 'r%MR t)0P0tK+4tnV%N
3. Builder's name +Ju.R Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition
5. Alteration
6. New Porch ,
7. Is existing building to be demolished? 0011
8. Repair after the fire
9. Garage No.of cars Size
10. Method of heating +J�
11. Distance to lot lines t'n Sk CME AQ-IL1 klzN-y
12. Type of roof
13. Siding house
14. Estimated cost:- Q
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The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief. A q
Signature of responsible applicant
Remarks
PRIN\7T.si�SHOP
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