29-338 (2) 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 SNFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This coltm to be fi22.ed in
by the Bai2ding Department
Required
Existing Proposed By Zoning
Lot size , 100
Frontage
�.qQ
Setbacks 40 1A
- side L: 40 R: -7-0 L: 40' R: 8
- rear �. r i
�� 30
Building height
Bldg Square footage SQ V!-T
%Open Space:
'(Lotarea minus bldg
&paved parking) d
# of -Parking spaces
Hof Loading Docks
Fill:
�(voliime -& location)
13 . Certification: I hereby certify that the information contained h e
is true and accurate to the best of my knowledge.
APPLICANT's SIGNATURE
NOTE: [ssuanoe of a zoning permit does not relieve nn nppii nrs burden to oompty with sil
zoning requlrements and obtain emfi required permits from the Baord of Health, Conservation
Commission, Department of Public, Warka and other npplloable permit granting authorities.
FILE t
A l T W6
_ File No.
ZONING PEFZM=LT APPLI C•AT-TON (§10 . 2)
PLEASE TYPE OR -PR�S�N,T ALL INFORMATION
1. Name of Applicant: t� ,�
Address: Telephone: IS71 8-A-�(,y
2. Owner of Property: � �} �+
Address: ? ? Q Telephone: 54 `tG k�
3. Status of Applicant: 'Owner Contract Purchaser Lessee
Other (explain):
4. Job Location: (
Parcel Id: Zoning Map# 7 Parcel# 4 District(s): &A4� �S
(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):
��� v�t %� :h�UCr �1 + L 7�' •... �"t.a•l. ��sZ �� t.rr�.,-��ti� ��Aa�S
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 Departrnent Files.
8. Has a Special Permit/Vahance/Finding ever been issued for/on the site?
NO 'w"' 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 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 # r` r n I
MAY 7 19%
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE:
PROPERTY LOCATION: D '
MAP_,� _ PARCEL: ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PER HT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
'Ryffldin2 Permit Filled nut
Adfiitinn to Existing
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION-
A 7 proved as presented based on information presented
Denied as presented:
I/as Spe ermit and/or Site Plan Required under: §
cial
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
/11 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
it fro Conse on Commission
(a7
Signature o Building Inspector to `
NOTE: lssuanoa of a zoning permit does not relieve an applicant's burden to comply With ail
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commisslon, Department of Publio Works and other applionble permit granting authorities.