32C-219 (38) 10. Do any signs exist on the property? YES _ NO
IF YES, describe size,type and location: kV,Ii/ 1-74VIL \�f'/���•'r
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 column to be filled in
by the Et djmq, Department
Required
Existing Proposed By Zoning
Lot size f t� $� 4t 7S�
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear -�
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&pa.ved parkingN
# of -Parking Spaces
# of Loading Docks
Fill:
-(volume -& location)
13 . Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my knowledge.
DATE: .fl3 a/9 d APPLICANT's SIGNATURE'�j''�^�
NOTE: Issuanoe of a zoning permit does not relieve a pp oant's burden to oomply wltla all
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commisslon. Department of Publio Works and other appiloable permit granting authorities.
FILE #
File No. (t'� � i
ZONING PERMIT APPLICATION (§10 . 2
PLEASE TYPE OR PRINT ALL INFORMATION
Eyr
1. Name of Applicant: 47 C r.
Address: 4a I A-14wl—cy ! � Telephone:
2. Owner of Property: f4°'r/t'"�
Address: 5-4--^-7e Telephone:
3. Status of Applicant: '7� Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: fl-2 1 ivtEY - r%
r
Parcel Id: Zoning Map# �Jdc Parcel# // 9 District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property 1`71'X
6. Description of Proposed UseNVork/Project/Occupation: (Use additional s eets if necessary):
-57j A 1P;87 i'�'/ca&lAc C�2 cu-r-
7. Attached Plans: Sketch Plan 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 PermitiVariance/Finding ever been issued for/on the site?
NO DON'T KNOA' 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 X_ 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)
1
i
FILE # � UJSG
APPLIC �YT (�NT�TACT PERSO�1 N: /l L
A >
A11) -R !��
(.f
PROPERTY LOCATION:
MAP 30) PARCEL: / ZONE_ 5,r
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
NCLOSED REQUIRED DATE
�r -
�J�/c� t
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
Approved as presentedfbased on information presented
Denied as presented:
��='t�lfalr Site Plan Required under: § a
L =BOARD ZONING BOARD
Received & Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § w/ZONING BOARD OF APPEALS
Received& Recorded at Registry of Deeds Proof Enclosed
Variance Required under: §_j. 5 w/ZONING BOARD OF APPEALS �Ok� J
(du�Nj
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 ommission Q
Signature of Building 11 or j7atel
NOTE:issuance of a zoning permit does not relieve an applicant's burden to comply with all
zoning requirements and obtain ail required permits from the Board cf Health, Conservation
Commission, Department of Public Works and other applicable permit granting authoritles.