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28-045 (3) i 10. Do any signs ebst on the property? YES NO x 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 cold to be fi 7 7..i is by the Bmildiw Department Required Existing Proposed By Zoning Lot size � `TS Frontage .273 , Setbacks -frnnt ' - side L: R: L: - rear Building height _ Bldg Square footage %Open Space: - *(Lot area minus bldg �//� IV/4 &paved parking) / # of Parking Spaces # of Loading Docks Fill: (volume & location) 13 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. DATE: Z APPLICANT's SIGNATURE NOTE: uanoe of as zoning permit does not relieve an applioan burden with all zoning requirements and obtain all required permits from the Board of He th, Conservation Commission. Department of Publio Works and other applloable permit granting authorities. FILE # JAN File No. a ZONING PERMIT APPLICATION PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: ED 1Jy4)2> 44 yi9L LE"� �jZ. Address:2• �E.[�T�-YL �7" /V �TDit.J Telephone: 5B4, —912?Z 2. Owner of Property: 42>4J,o,122> LA �i4LL�y J'�2 `� 1 N E�2b��f D d.�¢U�, Address: .SA!l7� Telephone: 3. Status of Applicant: Owner Contract Purchaser Lessee _Other(explain): I $E 17El.DED Fkom M07-HfIG ?a .56,4-) 4. Street Address: S13 9YAAJ Rv A t _ .28 =¢z., g3, f 94 Parcel Id: Zoning Map##:'2!ej' _ Parcel# /ZZ District(s): .5/0 (TO BE FILLED IN BY TH E BUILDING DEPARTMENT) 5. Existing Use of Structure/Property op'6F-w 44, z> 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): 7. Attached Plans: Sketch Plan X _Site Plan Engineered/Surveyed Plans 'DW6 *96 -00 3 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 DONT 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 YES �c IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained ,date issued: p (FORM CONTINUES ON OTHER SIDE) E- ��C i4svD 75 02z;15S E.Y/ST/-Y,y _ C04,1/65W--r h� U7'1417'145:-�. � JSo FILE'. # � APPLICANT/CONTACT PERSON., �� 2� V C2&Q ADDRESS/PHONE: a/ �2 PROPERTY LOCATION: MAP PAV,'TION: ZONE k FOR�OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE Fee Paid 1Ryjildin2 Permit Filled nut Fee Paid Tvnr of t onstrurtion- New C'nn-,trnrtinn Remndelin2 Tnterinr Aridition to FYicti Arre-,-,nry Strnrtnre Wilding Plan-, TnrInded- Owner/0rrn[)nnt StatPmPnt nr T Set-, of Plane / Pint Plan THE FOLLOWING ACTION HAS BEEN TARN ON THIS APPLICATIOM 1 Approved as presented/based on information presented X Denied as presented: J Special Permit and/or Site Plan Required under: § PLANNING 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 I 1 Variance Required under: E; (o w/ZONING BOARD OF APPEALS �� J ioo, V1 Received&Recorded at Registry of Deeds Proof Enclosed w8a f� xw Other Permits Required: Curb Cut from DPW _ Water Availability Sewer Availability Septic Approval-Bd of Health _ Well Water Potability-Bd Health Permit from Conservation Commission Signature of Building Inspector Date NOTE: issuanoe of a zoning permit does not relieve an applioant's burden to oomply with all zoning requirements and obtain all required permits from the Board of Health, Conservation Commission, Department of Publio Works and other applioable permit granting authoritles.