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Date Filed 5 t C f ? ' L.a� File No / J , / - I0
REGISTRATION OF HOME OFFICE /OCCUPATION ( §10.2 & 11.11) -
With the Building Inspector _ •
1. Name of Applicant: 1-o V' &.. NA, - 4(_d(\. AZi
Address: 1 -1' 46 15 eta(' e rd . Telephone:_
2. Owner of Property: ' A V:9Lv 4.4 e. Pc yte e - eit"h . 1�V1. At e
Address:, '- p g r to4 q e, d T l ephone :_
3. Status of Applicant: /Owner Contract Purchaser Lessee ,
Other (explain: )
4. Parcel Identification: Map g , Parcel P ,
Zoning District(s) • (include overlays) .
Street Address Lt-1--0 TS Yt O 4 - ire(. F L tr L.AL
5. Narrative Description of Proposed Home Office: (Use additional sheet
•if necessary) oLli •,, _ • V O V1_ t /�z b ac
,A. V .. _..�! ■■•
' 0
6. Is this a legal residential building ?. YES le
.7. Will there be an employee /owner who doesn't live in the home Y 4101
• 8. Will you ever see client or customers at your site? YE NO
How often 4 1...Pq p
For what purposes V4 � t+ m.*S a c f)( CJ i - . .
9. Will there be any signs for the Home Office? 0110 NO
10. Will there be any goods sold from the premises or any sale of
goods stored on premises, either retail or wholesale, or any
display of goods on premises? NO
11. Will there be any outdoor storage of materials? YES 4
12. Will your use be totally within a building and not cause any
outward manifestation (including traffic generation; parking
congestion, noise, air pollution, and materials storage) ? NO
If NO explain: ,
13. Attach Plans (if applicable) ' •
14. Certification: I hereby certify that the information contained herein
is true and accurate. I understand that if any information is incorrect,
my permit is null and void and I may be liable for non - criminal fines and
criminal and civil actions.
Date: A Applicant's Signature:
�7�?il C Q PP //L�J / A/ - .
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented /based on information presented
APPROVAL EXPIRES ON DECEMBER .31 OF THIS YEAR AND MUST THEN BE RENEWED
Denied as presented - -- Reason: -
Signature of Building Inspector Date
NOTE: IrsJanco of a perrntt does not rollovo an applicant's burden to oomph' with all zor.Ing roqutremants and obtain alt roquirod pormlta
from the Board of Hoatth, Conzarvation CommIsston, Department of Public Work: and other applicable permit granting authoetios.
,
10. Do any signs exist on the property? YES NO V
IF YES, describe size, type and location:
•
Are there any proposed changes to or additions ofsign§ intended for.thp property? YES t/ NO
•
IF YES, describe size, type and�Iocation: I •e- • x 2-- -�.. a : 't s/v4!-°i
-- nn , ,,DD'
14 A
•
11. ALL INFORMA!'O N • MUST BE COMPLETED, or RERMIT CAfi , BE. ` DENIED DUE TO
LACK OF INFORMATION.
This cola= to be fizzed is
by the Building Department
Required
Existing Proposed , . By Zoning
•
Lot size
Frontage
Setbacks - front
side L: — R: L: :R:
- rear
Building height
Bldg Square footage 2 4
%Open Space:
(Lot area minus bldg
&paved parking)
# of Parking Spaces /� I
it of Loading Docks
Fill:
{ vol -time -& location)
13 Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DATE: APPLICANT'S SIGNATURE
NOTE: Issuanoe of a zoning permit does not relieve an applicant's burden to oompiy with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Pubiio Works and other applicable permit granting authorities.
FILE I
•
File No.
ZONING PERMIT APPLICATION ( §10.2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: t--Co trWttet.. 6k 14-0,11.e--
Address: + 0 a( t . . - Telephoner ( :f CS) Co 4 ( f .
2. Owner of Propert A v .e i e Pei Y 1/4 . ¢ 7 L - - o ' v r - ` e i H & 14 1 4 4 . , v 1 , - e . „ 1C 5 riot r ,se-0( . Telephone: ( LI l3) Co R . s - 9s - to 4 7 1
3. Status of Applicant: jOwner Contract Purchaser Lessee
Other (explain):
4. Job Location: uk d r . (e r-t tai . v�_'�
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property 4 r4 5-l--t44/ O
6. Description of Proposed Use/Work/Project/Occupation: (Use shee
7
if necessary):
7. Attached Plans: Sketch Plan 'V Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special PermitNariance/Finding ever been issued for /on the site?
NO DON'T KNOW / YES IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW YES
IF YES: enter Book Page and/or Document #
9. Does the site contain a brook, body of water or wetlands? NO 1 DON'T KNOW ! YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , date issued:
(FORM CON11NUES ON OTHER SIDE)
.
•
File # MP- 2010 -0052
APPLICANT /CONTACT PERSON PAYNE ANDREW C & LORETTA M KANE
ADDRESS/PHONE 470 BRIDGE RD
41 , ON "cl AD
*VI" 17B PARCEL 006 TiorZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out �/
Fee Paid Y�
Tvpeof Construction: HOME OFF /OCC REG - SALON
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets of Plans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRESENTED:
Approved (✓Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER : §
Intermediate Project : Site Plan AND /OR Special Permit with Site Plan
Major Project: Site Plan AND /OR Special Permit with Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: § .350 — 14 1 2-
Finding Special Permit t,V Variance*
Received & Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Commission Permit DPW Storm Water Management
/0 _
ignature of Building Official Date !!
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health, Conservation Commission, Department
of public works and other applicable permit granting authorities.
* Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact the Office of
Planning & Development for more information.