25C-257 (3) _ / P
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 �\ hO
IF YES,describe size,type and location: / t' 'i 1 ' '/I
J1t'k i'd f �,N 1-1_,0 In I S 4 L7/ ! S n i M I
11 . ALL INFO ION MUST BE COI PI ED, or J ERMIT CAN A DEN�ED SUE TO 4_
LACK OF INFORMATION.
This color= to ba
filie,l ir-
by the Building J>_-P irtt 1'.'t
Required I
Existing Proposed By Zoning
P.
Lot size
Frontage i.'`
Setbacks - frnnt AJA n-, -
__ _ _l
- side L: R: L: R:
- rear
v
Building height � ,.;tlVy
Bldg Square footage
5 I
%Open Space: .
(Lot area minus bldg �a ��S►rz.
&p=aved parkLngi }.n
# of -Parking Spaces .I ! _
f of Loading Docks <J
Fill:
{vol-ume -& location)
i,
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge .
DATE: APPLICANT's SIGNATURE q� _
NOTE: issuanoe of a zoning permit does not relieve an applio#nfrs burg n to comply witty all
zoning requirements and obtain all required permits from thel Board of Health, Conservtatioii
Commission, Department of Publio Works and other applicable permit granting authorities.
FILE #
File No.
ZONING PERMIT APPLICATION (§I0 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: A Jt^g<-
Address: 1 I'7-0, Ir- Telephone: c "
2. Owner of Property: Srj.�^1' L _
Address: Telephone: VV =? <
3. Status of Applicant: X, Owner _Contract Purchaser Lessee
Other(explain):
4. Job Location: f �_Q I ►� ��
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property 11tw+�
6. Description o�f_Proposed Use/Work/Project/Occupation:_(Use additional sheets if necess/dry
1'f d �`�{c c'��irk* �i/lt S ti y ?/2 Y►9 G'1 i�c�✓�� �_GZ_
f l�X ra W ,r �, zn �
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.
�4t ou✓v`�
8. Has a Special Permit/Vadance/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 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 �ES to
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)
y ,, _ P _
I 7'I 7
I`-5 n 4. rt10 Y
D ate Filed 'nGr File Igo.
3
REGISTRATION OF ROME OFFICE/OCCUPATION (510 . 2 & 11. 11)
r "'With f the Building Inspector
1. Name of Applicant: v( ". 61`tr, .1
Address : 15 ( � �t^ ` t r:'✓� _ Telephone: �Z � �/� j��T�_
2 . Owner of Property : :14
Address: / �� �� �j; �; _� Telephone:
3 . Status of Applicant: x Owner Contract Purchaser Lessee
Other (explain: _ 7L _ )
Parcel Identification: iiap x � Parcel f X5;7
Zoning District(s) (include
Street Address 1 S ( .a i iL a I
5 . Narrative Description of Proposed Home U`fice: (Use additional_ sheets
if necessar ) ► �� /( t j(,P �f l zn
ff
t G C ll(3Zr C _U f l'ne
i 1 6
I��r,.r✓S E^'��.�� c��•^..� �1`� +�'! T���-2�!!�'F-(�--t e.;vie1 r'U2�nZ�. �+i .,s.�n�C T��S � ")L i 1"
s-
6 . Is this a legal residential building? yE
7 . Will there be an employee/owner who doesn't live in the home YES GNQ.)
S . Will you ever see clients or customers at our site? (!�E�� NO
How often Lr �� �; 4� . ( ' c� pry . Glc� c For what purposes till ;c ? �,ntr��_ �_ s c `f��►E�-
9 . Will there be any signs f r the 'Home Off fice? YES NO
1-0 . 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? YES NO
1 Will there be any outdoor storage of rater_ i-als? YES 3v0
12 . Will your use be totally within a building and not cause any C
outward manifestation ( including traffic generation, parking
congestion, noise, air, Dollution, and materials storage) ? YES)NO
If NO explain: W• ) ,r -0f
1.3 . Attach Plans (if applicable)
1�0 �vit. �'r n t 3 �� t Yi a� d V� rvz*✓✓ ,✓
14 . Certification: I hereby certify" hat 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: ( ,( � �� Applicant's Signature:_
THIS SECTION FOR OFFICIAL USE O
_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: lasuanco of a poTm1t does not rollovo an appllcant'a burdon to comply with all zoning ro-qulrnmonts and obtain all roGulrod pormlt3
from t vQ Board of Hoalth,Consorvatlon Commission, Dopartmont of Public Work3 and othor appllcablo pormit granting authorltlos.
L
File#MP-2003-0085
APPLICANT/CONTACT PERSON ZOERNIG M JESSE
ADDRESSJPHONE 15 FAIR ST (413) 582-1299 O
PROPL I
I
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: HOME OFF-OCC REG-THERAPEUTIC MASSAGE
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 rtz'�Ttx `"Cc`��ut'G�ti
Major Project: Site Plan AND/OR Special Permit with Site Plan ,
ZONING BOARD PERMIT REQUIRED UNDER: §
T �
Finding Special Permit L-� 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'C�07ssion
Signature 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.