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DEPARTMENT OF BUILDING INSPECTIONS
INSPECTOR 212 Main Street ' Municipal Building 'f
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 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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Zoning
Miscellaneous Additions,Repairs,Alterations,etc. Tel.No._^'�` ��'" c��r� Alterations
so NORTHAMPTON, MASS. 19 !! Additions
Repair
APPLICATION FOR PERMIT TO ALTER Garage
1. Location 303 d e r,It& r 11 Lot No: dF p, 1,22-
2. Owner's name R e Address 303 Pj 04So+ale (_r rd e— A r d,4.- a i-,,
3. Builder's name Address
Mass.Construction Supervisor's License No. Expiration Date
4. Addition /
5. Alteration V4- Li'nr i e�X
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 e 1e-cir ; C-
ll. Distance to lot lines
12. Type of roof
13. Siding house
14. Estimated cost:-
(ha� h The undersigned certifies that the above statements are true to the best of his, her
knowledge and b ief.
Signature of responsible applicant
Remarks t1" , .0 f e l_ f-4
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