32C-284 (16) 10. Do any signs exist on the property? YES NO ✓
IF YES, describe size,type and location:
t
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.
Thi: col- to ba filled in
by the Bnildinq Department
Required
Existing Proposed By Zoning
Lot size Ll f f
tl
Frontage
Setbacks
- side L: R: L: R:
- rear
Building height �� Fl.�, � �- f,�•F�
Bldg Square footage
%Open Space:
(Lot area minus bldg n
&Paved Parking] [
# of `Parking Spaces
t of Loading Docks
Fill:
{volume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DATE: 1 3 �� APPLICANT'S SIGNATURE �-
NOTE: Issuan a of a zoning permit does not relieve an applioanY en to oompty wito eli
zoning requirements and obtain all required permits from the Board of Health, conservatior
Commission, Department of Publio Works and other npplioabie permit granting authorities.
FILE #
001 a
FEB 42 Fi 1 e No.
IONS
O�NOR�° T APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: 3U �r✓ /�v� , Telephone:
2. Owner of Property:
Address: Telephone:
3. Status of Applicant: �/ Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: z
Parcel Id: Zoning Map# �J c�(�7' Parcel# District(s): _ z,
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Descri ption of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
CW
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 Department Files.
8. Has a Special PermitNadance/Finding ever been issued for/on the sit/e?
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#MP-2001-0096
APPLICANT/CONTACT PERSON DALEY BRYAN A
ADDRESS/PHONE 3 MONTVIEW AVE (413)586-9169 Q
PROPERTY LOCATION.3 MONTVIEW AVE
m,
i ",� r1RG7� 4' QNI� URC s
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
4np,OPennit LLED OUT
illed o ut
Fee Paid
T_ypeof Construction: INSTALL 2ND CURB CUT
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structure
Building Plans Included• -
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
Approved as presented/based on information presented.
Denied as presented:
v Special Pepit and/or Site Plan Required under: § S 1 —7
l/ 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 Board of Health Well Water Potability Board of Health
Permit from Conservation mmission Permit from CB Architecture Committee
Signature of Building Official 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 of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.