17C-220 (22) Assessor's Map
11. List of Abutters:
/ Address Sheet No. Parcel .
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26. 9EPT 9
ON.MA.01060
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(Attach additional sheets, if necessary)
P IMT P
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es Application Number: �C I
0 ec ed Filed Fee Pd. Rec'd. ZBA Map(s) Parcel(s)
4.
Date r1
L to Date Amt. Date By Date
JUN DEPT. OF BHEH
AP RIF T(ONAl �R MADE TO THE CITY OF NORTHAMPTON ZONING BOARD OF APPEALS:
I
1. Name of Applicant — -
Address
2. Owner of Property
Address
3. Applicant is: Owner; ❑Contract Purchaser; ❑Lessee; ❑Tenant in Possession.
4. Application is made for:
❑VARIANCE from the provisions of Section page of the Zoning Ordinance of the
City of Northampton.
OSPECIAL PERMIT under the provisions of Section page of the Zoning Ordinance
of the City of Northampton.it
(OTHER: 1' ]D/l 6— AomA, Q(�15/b o� !�rCTbltl 7 (a Pg6,,-n--
5. Location of Property 11I being situated on
the 22-2 � side of We , n shown on the Assessors' Maps,
Sheet No. Parcels) oC
6. Zone—(r?
7. Description of proposed work and/or use;
8. (a) Sketch plan attached-; 0 Na .
(b) Site plan: ❑Attched ❑Not Required
9. , et f th re ons2upon which applica i s based:
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10. Abutters (see instructions; list on reverse side of form).
12. 1 hereby certify that information contained herein is tru the best of wledge.
Date 00� JApplicant's Signature
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JUN
Aq) s/ )i N16— C� Un.Of BUILDING INSPECTIONS
h. RuIPiON AM.01060
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CITY OFINORTHAMPTON
ININU PERMIT APPLICATION + d x Map No. ��f/ Lot
�Zoning Ordinance Section 10.2 W110 a No. Plan File
CO1110- BU LDING INSPECT
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one ��� n`� �� Telephone _
action is to be filled out in accordance with the "Table of Dimensional and Density Regulations:
(Z.O. ARTICLE VI)
Use Lot Front Depth Setbacks Max. Bid. Min. Op.
t Area Width Front Side Rear Cover Space
0�
Existing 0°
t Proposed % %
he appropriate box to indicate the use of the parcel:
i
• Non-Conforming Lot and/or Structure. Specify /`/OAl
• Residential ❑Single Family Unit ❑Multi-Family
❑ Duplex ❑ Other
Business
• 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)
hed Protection District Overlay: (Z.O. Sect. XIV) ❑ Yes YIN o
] Space Requirements: (Z.O. Sect. 8.1) Required Proposed v j)
g Space Requirements: (Z.O. Sect. 8.2) Required Proposed-
(Z.0. Art. VII) a es O No.
imental Performance Standards: (Z.O. Art. XI I) O Yes QXO
an ❑ Yes C5 No Site Plan ❑ Yes Q,N'o
2) (S. 10.2 and 10.11
Waiver Granted: Date ❑
s section for OFFICIAL use only:
❑ Approval as presented:
p Modifications necessary for approval:
Return: (More Information needed)
Denial: Reasons: (( ? _l7
ure o A licant Date Signature of Admin. Officer Date
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