32A-121 Additional Info.pdfMM" "
"Tr t t r r tTIJ 7IT-TIORT-M25"
City qfNorthampton
1. Name of Applicant: inj '6Qawfai:7 60t"&g—
Address: oi2MAf leb Telet)hone:
2. Owner of Property:
Address: -*tl k Telephone: Ott) '5abr 100o
3. Status of Applicant: Owner Contract Purchaser Lessee Other (explain
4. Job Location: CACLIQ
5. Existing Use of Structure/ Property:
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sqeets if nqces * ry):
Wt WQULt2 U SOLAAP—' JMW" CAQei5�21' 114 -vat
4XLS1C'1k Lau,
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7. Attached Plans: Sketch Plan Site Plan Engineered /Surveyed Plans
8. Has a Special Permit/Variance/ Finding ever been issued for/on the site?
NO V DON'T KNOW YES IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO V/ DON'T KNOW YES
IF YES: enter Book Page
9.Does the site contain a brook, body of water or wetlands? NO V/
and/or Document #
DON'T KNOW — YES
Needs to be obtained Obtained date issued:
{Form Continues On Other Side)
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Zits\FO—RMS—\o,.gi.,d\13.ildi.g-I,,p..tor\Zonihg-Permit-Application-passive.doc 8/4/2004
1/10. Do any signs exist on the property? YES Np
IF YES, describe size, type and location:____
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