08-021 Petition to BOAppeals 764 No. King St.Nww Z00)(Da( *41e
City of Nnrtbarnpton Maggacbusrttg
BOARD OF APPEALS
Z Ll� bkD�� (
Room 15
City Hall
Notice: —This petition must be filled out in ink or typewritten, filed in triplicate and accompanied by 3 sets of
plans of the affected premises showing location, dimensions and area of the lot, and the locations, dimen-
sions and the distance from the boundary lines of all structures erected and to be erected. It shall be
filed at the office of the Board of Appeals and shall be accompanied by a filing fee of $10.00.
PETITION TO BOARD OF APPEALS
Petitioners) ..........1...0..X .. ...........�...Q2.tx 1n�.1..Q- 36_:C ..... ....... _...„ Address
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The petitioner is the owner, lessee, tenant in possession, has a written contract to purchase or lease the premises affected by
this petition. (Cross out inapplicable words, not applicable to petitions for review).
Permit under the provisions
Petition is hereby made for a Wamiwiayw,from the requirements of
Review of a decision of the Building Inspector under
Section ..........._..._._ paragraph of C. 46 of the City Ordinances of the City of Northampton.
The Premises affected are situate on the North ..... ........... _. South.............. East ... ........ West_:. : side of 1A..,
Street; \ M._I &L.. feet distant from the corner of . a. _1 ..... _D„ � .„„.. w Street and are known as No.
Street.
Description of 'Ejiltin d Building
1. Size of building :._ .................. ...................... _.._ front _.._........_ . .._ / 4. - .—feet deep.
Height .... stories: _..._......_.._._ ... ......... ......... .... ............ feet.
1 n _
2. Occupancy or use: (of each floor)
3. Zone District F i...._. 4. Date of erection (only if already existing)
5. Has there been a previous petition concerning the affected premises? ........_....�f\ 9.. ... ......... ...... ........
_....
6. Description of proposed work and use:
7. The reasons upon which I base my petition are as follows:
Da Signature or agent
I (we) hereby certify that the persons named below are all the owners of the property adjoining the premises affected, and
are all the owners of all the property within a distance of 200 feet of any boundary of the prfmises - cted as they appear on
the most recent tax list.
. .c�d�_ .._._` ._` _.. _ _A .... _ ... ._.................
Signature o ow or agent
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PERMITS ISSUED
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BOARD /COMMISSION: PTAWNING BOARD
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PERMITS ISSUED
BOARD /COMMISSION:
CONSERVATION COMMISSION
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