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29-215 (3) s e 'e Date Filed File No. �_"ak_c i REGISTRATION OF HOME OFFICE/OCCUPATION (§10. 2 & 11. 1t With the Building Inspector 1. Name of Applicant: Address: t.2 ti hl�2�.nr; , ..,.! ,,�,_, ti2� . Telephone: 2 . Owner of Property: Address : Telephone: 3 . Status of Applicant: �--Owner Contract Purchaser Lessee Other (explain: ) 4 . Parcel Identification: Map , Parce , Zoning District (s) (include over ays) v aj Street Address �� � Vic:{3�c2•� �7,m. 5 . Narrative Description of Proposed Home Office: (Use additional sheets if necessary) M,j,<,+ 4 6 . Is this a legal residential building? AM8 NO 7 . Will there be an employee who does not live in the home? YES dab' 8 . Will you ever see clients or customers at your site? YES 901 How often For what purposes 9 . Will there be any signs for the Home Office? YES d—TO 10. 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 Mb 11. Will there be any outdoor storage of materials? YES 12 . Will your use be totally within a building and not cause any outward manifestation (including traffic generation, parking congestion, noise, air pollution, and materials storage) ? ACES NO If NO explain: 13 . Attach Plans .(if applicable) 14 . Certification: I hereby certify that 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: (�k Applicant's Signature: -/ n .(.) THIS SECTION FOR OFFICIAL USE ONLY: Approved as presented/based on information presented APPROVAL EXPIRES ON DECEMBER 31 OF THIS YEAR AND MUST THEN BE RENEWED Denied as rese ted-;-Reason: AUG 1 a 1997 signafte&7131 Suilding In ctor Date NOTE: Issuance of a permit doe-snot relieve an applicant's burden to comply 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.