36-056 (9) (l ifs of 'Norillamptult
�H56AGI�l(IItt�S �
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.HOMEOWNER 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. 8'1 06 [ Alterations
so NORTHAMPTON, MASS. 19� Additions
APPLICATION FO� PER IT TO ALTER Repair
Garage
1. Location 4( Red4/J Loot No. �,/�
2. Owners name OY1 ° Tl>1/� Address �� Re 8 `, ,�,9 e)r. � I6�C'nc(" P 1 A��,//
3. Builder's name �— Address �� k r,)Y °S�
Mass.Construction Supervisor's License No. ExpiratiQu Date
4. Addition f d il'�j_Z) n
5. Alteration
6. New Porch
7. Is existing building to be demolished? y
8. Repair after the fire N D
9. Garage Av 0 No.of cars Size
10. Method of heating Q F r
11. Distance to lot lines Froni 60' Z-5' f L a t d
12. Type of roof V I
13. Siding house 0 VA ska N
14. Estimated cost:�/9 J drE)
The undersigned certifies that the above statements are true to the best of his, her
knowledge and belief.
WL. �,�--
Signature of responsible applicant
Remarks
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