37 -077 ZPA 2013-11-07-----
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File # MP-20 1 4-0044
APPLICANT/CONTACT PERSON KJK WIRELESS PCS LLC
ADDRESSIPHONE 12 OLD TAVERN LANE (508) 868-0927 0
PROPERTY LOCATION 790 FLORENCE RD
MAP 3"1 PARCEL 077 001 ZONE
THIS SECTION FOR OFFICIAL USB ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
vtC)NING FORM FILLED OUT
~ePaid
Building Permit Filled out
Fee Paid
TypeofConstruction: ZPA -ADD ANTENNAS & EQUIP BLDG (CINGULAR WIRELESS)
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included:
Owner/ Statement or License
3 sets ofPlans / Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION P0.NTED:
__Approved . Additional permits required (see below)
PLANNING BOARD PERMIT REQUIRED UNDER: § 3S0 -A1\ I~ \0
Intermediate Project: }/' Site Plan AND/OR. ___Special Permit with Site Plan
Major Project___Site Plan AND/OR Special Permit with Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: ~__________
Finding,_____ Special Permit _____ Variance*
___Received & Recorded at Registry of Deeds Proof Enclosed._____
__Other Permits Required:
Curb Cut from DPW ___Water Availability ___Sewer Availability
___Septic Approval Board ofHealth ____Well Water Potability Board ofHealth
___Permit from Conservation Commission ___Permit from CB Architecture Committee
__-,Permit from Elm Street Commission
Signarure~fficij ~ Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board ofHealth, Conservation Commission, Department
of public works and other applicable permit granting authorities.
* Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact the Qffice of
Planning & Development for more information.