32C-179 (29) 10. Do any signs exist on the property? YES NO
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES _ NO
IF YES,describe size,type and location:
11 . ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This colLmn to be filled i.n
by the Building Department
Required
Existing Proposed By Zoning
Lot sizes
l �
Frontage -2 C) /a L
Setbacks d /0
- side L: R: L:_ R:
- rear /
Building height YD
Bldg Square footage 33 i (�
%Open Space:
(Lot area minus bldg
&Paved parking) (
of -Parking spaces ZOO 6/�dlND��IT,y� �-
c�/�, ;� 3
Loading Docks
location)
4on: I hereby certify that the information contained herein
accurate to the best of my knowledge.
— APPLICANT's SIGNATURE
.ing permit does not relieve an ap lioant's burden to oomply with uu
.nd obtain all required permits from the Board of Health. Conservation
.nent of Publio Works and other applioable permit granting authorities.
FILE #
NOS, 3 ,
File No. 9//w t�
ZONING PERMIT APPLICATION (§10 . 2
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: j4)� 6!F- / 7t 41XA)
Address:15 (As fir- [Acj I)or..J 12t) FC.b6'i f A cLTelephone:( G-) SY6 (N)5E
2. Owner of Property: '4&j r>L
Address: Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain): ,g '
4. Job Location: -53 L `" 3 3 Y gLe6a'J&"4 3�: `vCV17em-4 r q
Parcel Id: Zoning Map#&2(!- Parcel#/� District(s): 6�p
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
Z
7. Attached Plans: Sketch Plan �,,Site Plan Engineered/SurveyedPlans� �
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special Permit/Variance/Finding ever beeen� issued for/on the site?
NO DON'T KNOB:� 1/ YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO 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 CONTINUES ON OTHER SIDE)
FILE #_ J U 3 0 2_S _
Nov
APPLICANT/CONTACT PERSON_ :
ADDRESS/PHONE:
PROPERTY LOCATION:
MAP ,���, PARCEL: ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERNIIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ED MIT
- _ ✓
Builrfin2 Permit Eillff] put
Addition to FAisting
3 Sptt n
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP LICATION-.
f Approved as presentedfbased on information presented
Denied as presented: � " n
L'�r t O �YrrC�Lf r�E, I C? (I) _ 7 tJC�� Ceti �r�t C�Y
-�' vyl(x,�� „eeck � -��Ict:r� n
Special Permit and/o Site Plan Re uire under: § Q
PLANN NG B ZONING BOARD �,��`� �6`Q wt„Ch
Received & Recorded at Registry of Deeds Proof Enclosed — -I f)Qce 1o0
�( Finding Required under: § )Y/ZONING BOARD OF APPEALSr
C-A&"n J_ I”) I6,i- C.CK,pol,_ r11 101t
Received& Recorded at Registry of Deeds Pr Inclosed
/
Variance Required under: § w/ZONING BOARD OF APPEALS
Received &Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
_Permit from Conservatio ommissi G
z Z
Signature o i g r Date
NOTE:Issuanoe of a zoning permit does not relieve an appllonnt's burden to oomply with all
zoning raquirements and obtain ail required permits from the Eocird of Health, Conservation
Commission, Department of Publio Works and other applionble permit granting authorltles.