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17D-071 (6) �v 0 7\-) l Zoning /Planning Application: Do NOT leave this page until it prints!!! Page 2 of 2 Pipe: 21U] ]pipe: 1851 On CLERK (SE: i (09 l) ,/11 _ ;u') / . Application must include fee and (except for <ANRs) 540 check made to 'Daily H 1 /4, am! shire INSTRUCTIONS to file application View Resuh s http: / /fsl2.forrnsite.com /fsI2 app /FormSite 11/5/2009 i v - 4 , Zoning /Planning Application: Do NOT leave this page until it prints!!! Page 1 of 2 it 4 ti Owner: 'pipe: 11 City otNorthampton Address: City Hall, Northampton, _Alassachusetts 01116( Applicant: 1 \1) .Adams /PV Habitat = Address: 140 Pinc Street, Florence, \1 issacliusetts (11062 413 586 5430, ed(t)pioneervaIILV habit ii 0H I represent under the pains and penalties of perjury that: 1. The information in this application is correct 2. Two copies of the application (EXCEPT for _ANR plans) have already been delivered to DPW. 3. I have _ALRF_ADI' posted the required sign on the property. 4. The O\ \'NI R has tuthoIi7 ity to inspect this property r 6 l B � % 1 . \pplicsult signature: t Owner Signature: C �' ¶rtrk I:acatton: 59 '$erot Street; I*lorence 01062 Map ID: 17D 471 -00t ed: Book 4685 Page 81, Zoning: URB Permit(s) Requested: APPROVAL NOT REQUIRED Surveys ($250 /plan page) Regulations: 350b Project: Revised ANR plan for Garfield Ave Extension PERMIT CRITERIA (IGNORE "pipe," it refers to permits you have not applied for.) Finding criteria [pipe: 2451 [pipe: 246] __ Appeal of Building Commissioner [pipe: 252] Ipipc 118! o ,t Comprehensive 40B Permit r [pipe: 1971 [pipe: 196] Variance .Application: [pipe: 249] [pipe: 2511 Special Permit and Site Plan Criteria: pipe: 2531: [pipe: 821 pipe: 2541: [pipe: 87] pipe: 255]: [pipe: 91] pipe: 2571: [pipe: 96] pipe: 256]: [pipe: 1021 pipe: 258]: [pipe: 1051 pipe: 2591: [pipe: 1001 pipe: 1561 pipe: 2611 pipe 1981 pipe: 1991 Requested Site Plan \VWaivers: http:// fs12. 1 /fs12_app /FormSite 1 1/5/2009