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10. Do any signs exist on the property? YES NO
IF YES,describe size,type and location: (I^j o"i
Are there any proposed changes to or additions of signs intended for the property? YES_ ---
IF YES,describe size, type and location:
11 ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE ro
LACK OF INFORMATION.
This column to be; tilled in
by the Buillrng T,--�artiomnt
Required
Existing Proposed By Zoning
Lot size 3
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&P-ived k3arking)
# of Parking Spaces
e of J�oading Docks
Fill:
(vol-ume location)
13 . Certification: I hereby certify that the information C(:)11La-L'N(-'c ct rein
is true and accurate to the best of my know edge .
DATE: APPLICANT"s' SIGNATURE
—
NOTE: luouanoe cif - zoning permit does not relieve an npplioWnt'a burden to. or-"-pl-y w-i
c� litt)-all
Zoning requireme-nta and obtain all required permits from the Board of Health, c.o-n**t!!r'-vtxtivn
Commivalonv Department of Publio Works and other a2ppiloable permit gretriting
FILE
r
- /
File No.
0 f� �3 ,3
Ci-�1 pf BU�Di�GINSPEC1lONS
PERMIT APPLICATION (§10 . ..:)
- PLEASE TYPE OR PRINT ALL INFORMATION
1. (l Iy
1. Name of Applicant: t �U I `-'��'Q
/i(i o -27
Address: L & ( � Telephone:
2. Owner of Property: A41 C ((} lI�j f� ) �� t5-A -�
Address: JAG b12� �� Telephone:
3. Status of Applicant: Owner Contract Purchaser�essee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map# r�C Parcel# 3 l District(s): `l
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
J
5. Existing Use of Structure/Property h',zA 6 C tSA-e-_A/
C h p-e'). - - ----
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessar�j • / /
O Qv: 1 to cc: LD U S E tit £
l7 ` 1 3?6 srzE-5 ' I- Wocu �
Co!►�0 h4 I-z> £K(S� SE� (5112 S zo&IRJ
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed I !c:.
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department f it c
8. Has a Special Permit/Vadance/Finding ever be -issued for/on the site?
NO DON'T KNOW YES IF YES date issi,•_: is
IF YES: Was the permit recorded at the Registry of Deeds?
1. 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
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-2003-0043
APPLICANT/CONTACT PERSON David McCutcheon
ADDRESS/PHONE P O BOX 43 (413) 529-9973
PRO
t NE URC
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FO FILLED OUT _
ee ai
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA-DIVIDE INTO 2 LOTS&BUILD 11 TOWNHOUSES
New Construction
Non Structural interior renovations
Addition to Existing
Accesso1y Structure
Building Plans Included:
Owner/Statement or License
3 sets of Plans/Plot Plan
THE FOLLOWING ACT N HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRE TED:
Approved V Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER: §
Intermediate Project: Site Plan AND/OR Special Permit with Site Plan
Major Project: Site Plan AND/OR Special Permit with Site Plan
�r
ZONING BOARD PERMIT REQUIRED UNDER:
Finding Special Permit Variance* r.--'
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 Commission Permit from CB Architecture Committee
a
Permit from Elm Street commission
Signature of Building O 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.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact the Office of
Planning&Development for more information.