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.n. D1.'Pi1R'flvfl.'N7' OP pUl1.U1�0 INSPl3Q'1'IQNS
INSPGCTCR 212 Main Street Atu»ief)�al 13ulld(ng .
Northampton, Mass, 01000
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,HOfrilrOWNER AND NOT A PROFESSIONAL CONTRACTOR IN NO WAY
ABSOLVES ME OF ANY RESPONSIBILITY TO INSURE THAT ALL FACFTS-
OF THE RULES AND REGULATIONS ARE COMPLIED WITH ,
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Zoning
Miscellaneous Additions,Repairs,
Alterations,etc. ,,- Tel.No. Alterations
so NORTHAMPTON, MASS. 1� 19 AdditionsRepair
APPLICATION FO PERMIT TO ALTER
Garage
1. Location / c°¢' ?j ��r,. f f<''. -7 Lot No.
2. Owners name 1��`Y+ r "� "� '� ! c" Address `/
3. Builder's name IA-41 Address / 7.f, ��'�6a 11�� amt - �G%�,.?T ,�•v /rt
Mass.Construction Supervisor's License No. CSt-I � Expiration Date
4. Addition
5. Alteration
6. Nrw�rc
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:- t C%o i
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
Signature of responsible applicant
Remarks
PA SNOP
Date , ''iled File No',
ZONING. Pk;ltMIT APPLIC.A` .1011
7,oniny orclinttnao Seati.on 10 , 2
1 , N-1.11 e of APJZJ.i.cant &1 ,�,i
Address21G
2 . owj)er. of Prn car. t: lJ✓��2=_�����_�'
Address : _-. Telephone !
3 St c3tUS o1.' � 1 ] ccSI1�t: : G' Olelll@), con'�:raci� Purchaser
L,clssec othc r (G;:t�].aa n7 )
41 Parcel_Identification : Zoning Map Sheet# Farce
Zoning District ( s 1K I
Street Adclress t� /:. c f
5 , ' Conlnli.a)�ce wit.il 7aani.ncr laxi.st3.ng Proposed
Use of Structure/property _C(.
Size of structure (sc1 ft , )
Building height
%
Building Coverage
'Setbacks - front
1, - ,.side _ 2� K 31.E
rear 7 7'
y
Lot Size
Frontage -
Floor Area Ratio
't Open Space
Parking spaces
Loading Spaces
signs
Fill (volume & location)
6., iar. ati,�ie Description of pronosecl Work pro ect1 ( Use
addit�dnal sheets if necessary)
f c.-
7 . Attached plans ; Sketch Plai) Site Plan
8 , Certjfica�.tor] ; hereby certify that the•'in�gprmation, oontained
herein is true and accurate to the best of my .knowledge ,
�'
Date ; G Applicant ' s Signature ; -�k �Zf��-
THIS,- SECTION FOR OPPICIAL USE ONLY :
Approved 'as presented
Denied as presented
Reason, for Den.ia 1 ;
Signature oe Ddilding Inspector.- ___��� Datre
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