35-005 (10) 10. Do any signs exist on the property? YES NO_ Ne__
IF YES, describe size, type and
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 XNFORM-ATTON.
Mtx C-T=mm to be ;6ZE12'ed im
by the 13'ai7,q4-q Department
Required
Existing Proposed By Zoning
14 S.
Lot size 1Lot 4--15
Lot 4 Z60, e-9
Frontage Lot-S 51,oo'
Lolr(o 1151-00'
Setbacks -frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking)
h�I -pf :Parking Spaces
Loading Docks
Fill:
'4vol-time-& location)
13 . Certification: I hereby certify that the information contained herein
i� is true and accurate to the best of my knowledge.
DATE: APPLICANT's SIGNATURE _ �;/-Z-
NOTE: Issuance of a zoning Permit doles not relieve an applicant's burden to oomply with.h all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other appiloabla permit granting authorities.
FIrF
v . JUL 61991
Y
Fi 1 e No. /
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE: TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:_�O'—e_ Lis �t1L
Address: . 0 401 Telephone:�W1–Soo j
2. Owner of Property:_ Sl�, � _►_� e� �i-lL1L
Address: Telephone:,tk�n—$CO
3. Status of Applicant: __—)(--Owner _ _Contract Purchaser Lessee
Other(explain):__
4. Job Location: _��, - ,Gy_ �� �4_aCd--��
Parcel Id: Zoning Map#— 11J _ Parcel#--,15. -- , District(s): PC )Q�
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property___\-&-ca Q4-_-LO _
6. Description of Proposed Use/VVork/Project/Occupabon: (Use additional sheets if necessary):
7. Attached Plans: Sketch Plan _ Site Plan !� Engineered/Surveyed Plans
Answers to the following 2 questions may he obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special PermitA/ariance/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 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
L- 61997
APPLICANT/CONTACT PERS N ' 5d
DEPT OF WMRES'S/PHONE: ��% �, 162 7
PROPERTY LOCATION:
MAPS ' PARCEL: ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
LED
Building Permit Filled wit
Type of Construction-
NP.v Cnnctrurtion
RPmnfielinu Interinr
Aririition to FYisting
Arrrccnr-v �trtlrtlir'P
$nil_ dint I lane Tnehirled-
(lwnPr/Orrrrnant ,'�tatrmrnt nr T irPncP #
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATIW
Approved as presentedfbased on information presented
Denied as presented: /
h Special Permit and/or Site Plan Required under: § �1 �� 2 �i l . �O (o, 1 l
__X_PI_.ANNING 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
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 Healt Well Water Potability-Bd Health
nit se ion
Signature of Building Inspector Ilale
NOTE: laauanoe 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
Commisslon, Department of Publio Works and other applioable permit granting authoritles.