25A-107 (37) 4'��
CITY OF NORTHAMPTON �°1 Mpr'°y
ZONING PERMIT APPLICATION Tax Map No.°, �, Lot
Zoning Ordinance Section 10.2 TIP Received: File No. Plan File
Owner Applicant
Address _ Address
Telephone Telephone
This section is to be filled out in accordance with the "Table of Dimensional and Density Regulations:
(Z.O. ARTICLE VI)
Zoning Use Lot Front Depth Setbacks Max. Bld. Min. Op.
District Area Width Front Side Rear Cover Space
Past Existing C r '1�� - �� % %
Present / Proposed
Mark the appropriate box to indicate the use of the parcel:
'Non-Conforming Lot and/or Structure. Specify
Cl Residential ❑Single Family Unit ❑Multi-Family
❑ Duplex ❑ Other
'VBusiness '
r
❑ Individual
Institutional
❑ Subdivision
❑ Regular ❑ P.U.D.
❑ Cluster ❑ Other
❑ Subdivision with "Approval-Not-Required"-Stamp:
❑ Planning Board Approval:
❑ Zoning Board Approval (Special Permit 10.9: Variance)
❑ City Council (Special Exception S. 10.10)
Watershed Protection District Overlay: (Z.O. Sect. XIV) ❑ Yes No
Parking Space Requirements: (Z.O. Sect. 8.1) Required Proposed
Loading Space Requirements: (Z.O. Sect. 8.2) Required Proposed
Signs: (Z.O. Art. VII) Yes ❑ No
Environmental Performance Standards: (Z.O. Art. X11) ❑ Yes [ANo
Plot Plan ❑ Yes I'No Site Plan ❑ Yes 'ANo
(S. 10.2) (S. 10.2 and 10.11
Waiver Granted: Date ❑
This section for OFFICIAL use only:
;Approval as presented:
❑ Modifications necessary for approval:
❑ Return: (More information needed)
❑ Denial: Reasons:
Signature of Applicant Date ignature of Admin.bffieer Date
THE PRINTING PRE55 " i