32C-224 (20) 10. Do any signs exist on the property? YES NO V
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 INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This co?— to be �fi11ed is
by the Bni2l:Ung Department
Required
Existing Proposed By Zoning
Lot size
Frontage a
Setbacks =fro n t -�
side L:$ R:_7 L: R:
- rear �z
Building height f
Bldg Square footage ?°`C, n f `
%Open Space:
Lot area minus bldg
&paved parking)
#, .Pf Parking spaces
# fof Loading Docks
Fill:
4vol-ume -& location)
13 . certification: I hereby certify that the information contained herein
rf is true and accurate to the best of my knowledge.
. �'l��
DATE: APPLICANT'S SIGNATURE
NOTE: Issuanoe of in zoning permit does not relieve an applionnt's burden t mply with all
zoning requirements and obtain all required permits from the Board of H it , Conservation
Commission, Department of Publio Works and other applicable permit gr ng authorities.
FILE #
File No. � C• y y"
ZONING PERMIT APPLICATION (§10. 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: a;$-I,,e
Address: / i„«� �,� �$7.� Telephone:
2. Owner of Property:
Address: 6In�wo.� �". M�� —Telephone: J-<--Y-41,.J`?
3. Status of Applicant: _Owner Contract Purchaser Lessee
Other(explain): ���
4. Job Location: 57���� /IFeY�lez, ✓l Z(Dx- A/d
Parcel Id: Zoning Map# 3.2 e Parcel# 2 District(s):
(TO BE FILLED IN BY THE BUILC51NG DEPARTMENT)
5. Existing Use of Structure/P rope rty�/ Z4�1 � -Z- ��rP
6. Description of Proposed UseNVork/Project/Occupabon: (Use additional sheets if necessary-,
-fir- 5 Pg��; r �,� �,�' 3-4c ,���-- Q�� e-
7. Attached Plans: V' 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.
8. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO____%!,e— 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 # 11
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE:
PROPERTY LOCATION:
MAP , PARCEL: ZONE ,5-Z "),e---�
THIS SECTION FOR-OFFICIAL USE ONLY:
PERNIIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM M.1,FJ) OUT
Fee Pnid
Rvii1ding Permit Filled nnt
Type of Constmirtion-
Striirtjire
Z c�,JZvt
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
Appro as presented based on information presented
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received& Recorded at Registry of Deeds Proof Enclosed
_Finding Required under:§ 4.3 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 Health Well Water Potability-Bd Health
Permit from onservation mission
Signature of Building Inspector Date
NOTE: tssuanoe of a zoning permit does not relieve an appiioant's burden to oompty with all
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission. Department of Publio works and other applioable permit granting authorttle-s. -