37-022 (2) 1(1 Do any signs exist 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 x
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 Building Department
•IRequired
Existing Proposed By Zoning
Lot size 11
Frontage - , 1 3
Setbacks - frnnt LL-o 1 -2-Z-d
- side L: R: L: R:
- rear
Building height 2s
�..- ., Mix --
Bldg Square footage
V"(S- TOTAL
%Open Space:
(Lot area minus bldg
v 0
&pved parking) 0 ��
# of Parking Spaces o CO 0
J
# of Loading Docks O p
Fill:
-{volume -& location)
13 . Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my knowledge.
1
DATE: 15-- 41-- APPLICANT'S SIGNATURE
NOTE: Issuan of a zoning permit does not relieve an eppiioanrs burden to oompty with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Public Works and other applicable permit granting authorities.
FILE
File No.
ZONING PERMIT APPLICATION 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: 1?/ ' \YAI S C_S.>440 vSi N'
Address:110 PCA.p/( I ILC, /20 41-11(EAT Telephone: 4tb S y 7 8 yg
2. Owner of Property: ) O&(Na 55c:<—/A—Tr,
Q O��''�'�L'
Address:31 c.ANPVS PLAZA J`Aa.E7 Telephone: '7(S L9P 3 21
3. Status of Applicant: Owner X _Contract Purchaser Lessee
Other(explain):
4. Job Location: LO f.(c. (`^0 L oT * `f
Parcel Id: Zoning Map# Parcel# p District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
S. Existing Use of Structure/Property W00 pen L0 j
•
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
Coils T'1=-ti c/17 a`v of 6 Z`( V '7' Ci�[O cs fti /N/L wait
ii'
Co N N'> se
7. Attached Plans: Y. 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.
S. Has a Special PermitNariance/Finding ever been issued for/on the site? /C
NO DON'T KNOW YES x IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES X
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 X ,date issued: '1 1 q gj
(FORM CONTINUES ON OTHER SIDE) ll