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29-381 (3) --AMINO r Co -n = r p 0 O g U) °� n a Z, 0 W w CL ", 0 .a v w 0 d1 Q) 3• c w, °L Yy o. �p w w J 0 OD iw) 0 Ch Ch H N p n 0 ;; �R' 7 O :j O a w N r' ON X r a c C� x g O to c (A a O C �1 W K 0 h Z H �. ( =r 171 �< H w A O 0 _ 7 ct X CD -n w 0 6" o o -% -p m z ° � ° o = (D ;< mn m CL N � 0 a w � CL a 171 A y o 0 (1).. �� m ;u CO) i g n -1 m CA Co M =r is N N w+ r. C� 3 O s n �D (D 9 m .. ND V tAl - 0 CD CD § t @ i-� 0 Cr 30 '. s O O W CL v c y 0 0 0 W Ah try a CA Oo cr N N O �l 0 o 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-,90-" NO IF YES,describe size,type and location: 11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION. Thin columm to be filled in - by tha Building Z�inr tment Required Existing Proposed By Zoning Lot size Frontage Setbacks - side L: R: L: R: - rear Building height Bldg Square footage %Open Space: (Lot area minus bldg &paved parki.ngi # pf `Parking Spaces t of Loading Docks Fill: _(vol-ume--& location) 13 . Certification: I hereby certify that the rmation ontained herein G is t e and accurate to the best of my owl dge. DATE: A.PPLICANT's SIGNATU NOTE: uanoe o a zoning permit does not relieve an applio s burden o oom zonin uirements and obtain all required ply ery .ail q Permi ro h Board of Health. Conservtatian Commission, Department of Publio Worker and other applioable ermit p granting authorities. FILE # 5 JA!1 —n 2 2 File No. f1 OF S ?1';; 3dcp. . .... ING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: k s t G Address: 1` ► ,© �n 1.nil �� \ e, Telephone: („_ 52 `7 6 -24 F - Ioa 1 2. Owner of Property:' o , �T��.,-+-1 S Llb) ,1 Address:_ r o t)V= x-) O t Telephone:_S!Z6- -7l 7 4 3. Status of Applicant: _Owner Contract Purchaser Lessee Other(explain): 4. Job Location: /7 drooL- c�out iY F�v✓�v�yc Parcel Id: Zoning Map# Parcel# G District(s): ✓Z � /���'�`�/�' (TO BE FILLED IN BY THE BUILDING DEPARTMENT), 5. Existing Use of Structure/Property Q ���� Di /✓v{,�'Q CY 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): d v- Al Ala✓P 4eek-) cr ye C k i-Z-4 - rIn toy-eS 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/Vadance/Finding ever been issued for/on the site? NO DON'T KNOV%f 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 t/ 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) L5 U L U FILE o 2 2X998 APPLICANT/C N CT PERSON: -7 `� ^bME: �E ORTHMM, T0N fi",i -C,60 PROPERTY LOCATION: Z at�GG`L� MAP PARCEL: ZONE THIS SECTION FOR-OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUII2ED DATE i Fee Pgid THF LLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION: ?' Approved 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: § 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 ____Per m Con rvat• si Signature of Building ector Dat NOTE:Issuanoa of a zoning permit does not relieve an applioant'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 applionble permit granting authorltles.