12C-041 234 spring grove board of appealsY A
.�x Q3 7 7 7
Tits o
BOARD OF APPEALS JUL
INSPECTION. Di
City Halt 4 NORTHAMPTON, A
Pailure to s-.lpply all required information shall be grounds for denial of this petition.
c otic( -: - This petition must be filled out in inx or typewritten_, together wit". seven
copies, and accompanied - by 8 sets of plans of the affected premises showing
location, d.imerisions and area of the lot, a.ad the locations, dimensions and
tiie distance from the boundary lines of all structures erected and to be
evectec. It srali be filed at the office of th6 li•ailuini Inspector arid shall
be accompanied by a filing; fee of ;;75.00 and a charge Of X2.00 for each
parson entitled to notice.
PE'1iTiOL TO b0At *.D OF APPEALS
P etitioner(s) .. 2 .. Address ..... ...............`
O"'Iner of
Premises l.�... ��' • • • z�. • Address.: �.
........ .... .... .................
q p(: ti t.ioner is the oviner, lessee, tenant in posseosior , has a, written con-
tract to purchase or lea.ie the premit�As affected by this petition. (Cross out
inapplicable words, not applicable to petitions for review).
Petition is hereby made for a ...............Variation fro- the requirements of
Sect ion....Y.'.f..9 :V�' g p .` ; 44 of the City Ordinances of the
y " d T'a -ra h • • . • • •. • • • • • • O f L
City of iJorthampton.
The Premises affected are situate on the... • • • • • • . side of 11'Wdj. • . . PWe
Street; desit,'nated as Parcel .... .....Sheet :o...j •C.. ••• the Assessors' Plan
of tiie City of .�orthampto :i and are known as.2.5 T. J.. v9 ?)':LC�l .: � r:Q Y.4°:. A v.. e....
Proposed A PpfTr O N
Description 6f e$ Building
1 . Size of Existing building... . . x. . .' ............... 0 ............ •••
Si ze of Proposed 1311ildirz ....•...i - ••i •••. •.• ...•••r•....••.•...•••.•••••.••
....
2. Occupancy or use: (of' each floor) ...... .......... '
. .. ... .. .......
. .
. . . . . . . .. . • . . . . . . . . . . . . • . . . ..# . . . . . . .. . . . . . . . . . . . . . • . . . . . . . . . . . . . .. . . . . . . . . . . .. . . .
3 . Gorse District ........... Y•••. ....•••••••....•• ............•..........••••••••
4. Has there been a previous petition concerning the affected premises ?...........
if yes; specify .................................. ...............................
• . . . . . . . . . . . . . . . . . . . . . . . . . . . • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . .
5 . je / s u rlptlon of proposed work arid use: ........ .••• •.•.••.••• ... ....•..••••••.
.... .�... r.� :. .•.........: :......�... .... .; .. ..
1
C .�e"/�r'r : !,y / .�: -•( •• /f .L.. ..e..
6. The reasons upon which this petition is based are as follows:
..... IL .:z` .... . a.�.. .. `
.. . . ..... . .. . ..... ..
.. .... ....... ... ..........
Date Signature of owner or agent
(OVER)