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SPACES FOR RENT
P.O.BOX 177RIYE
NORTHAMPTON,MA 010604177
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Date Filed 6,�,� �� �' File No.
ZONING PER14IT APPLICATION (§10 . 2)
1 . Name of Applicant : � f,r F
Address : qy <ivr�ustr�tr/ L�,P�vT�U���ha ��►�[Telephone:
2 . Owner of Property: /`j0kcft-1 T ya-aaIf
Address : �'�t�.� �'ff Telephone:
3 . Status of Applicant: )� Owner Contract Purchaser
Lessee Other (explain: )
4 , Parcel Identification: Zoning Map Sheet# 064- Parcel# 18,�A ,
Zoning District (s) (include over ays)
Street Address^ ��� h 1 1�
Required
5 . Existing Pro nosed by Zonincr
Use of Structure/Property S &-6-
(if project is only interior work, skip to #6)
Building height
+ ) %Bldg. Coverage (Footprint)
front
;1 minus
/ ion)
of Propos d Work/Project (Use additional sheets
7 . Attached PianS : - - --_._ Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
Date: '�r --��--- Applicant ' s Signature:
THIS SECTION POR OT'PICIAL USE ONLY:
,Approved as presented/based on information presented
f Agnas presented
fo e a1 :of Bui ng Inspector Date z
NOTE: issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning requirements and obtain all roquirod pormits
from tho Board of Health, Conservation Commission, Department of Public Works and other applicablo permit granting authorities.
7/92 FXAS