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34-024 (5) 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 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 column to be filled in by the BuilAi.ng Department i Required Existing Proposed By Zoning Lot size Frontage Setbacks - frnnt - side L: R: L: R: - rear Building height Bldg Square footage %Open Space: (Lot area minus bldg ' &Paged Parking% # of -Parking Spaces # of Loading Docks Fill: Avol-ume--& location) 13 . Certification: Thereby certify that the information contained herein G is true and accurate to the best of my knowledge. DATE: APPLICANT's SIGNATU �� - NOTE: lasua oe of a zoning permit does not relieve an applicant's burden to comply wltla�atl zoning requirements and obtain ail required permits from the Board of Health. Conservotion iCommisaion, Department of Public Works and other appiloable permit granting authoritiou. FILE # r1 l g e% Ei 1 e No. , •M� ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: leo ®,,,11v�5 zw, / ` n711 Address: Telephone: Owner of Property: fbLY�&e-ky�W6 _S, £X S'7&1V-E COhIEN Address: 7T��� ��Q_/T �S 113, 12 ' t,; Telephone: 4(3-S�Vf-,20Xf7 c-(3-5Y - 3. Status of Applicant: _Owner Contract Purchaser Lessee Other(explain): 4. Job Location: TylefC N`tLL Parcel Id: Zoning Map# 0,3Lf _ Parcel# ® '[ District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) S. Existing Use of Structure/Property CM;4t OW Piet 116 — C 0S#60 fnAJ& SU6*6 6. Description of Proposed Use/Work/Project/Occupabon: (Use additional sheets if necessary): L,A 42�K Tor' EN7ee tr' 7a Cdl+wvorA/ /eVAP U 10 7a I&"67E 14AI-Q 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 Permit/Vadance/Finding ever been issued for/on the site? NO DON'T KNOW � YES IF YES,date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW V 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 V Obtained ,date issued: (FORM CONTINUES ON OTHER SIDE) ` r FILE 1 � jN APPLICANT/CONTACT PERSSOI /' "-/-? - ,, �i ADDRESS/PHONE ;LC PROPERTY LOCATION: MAP l PARCEL: ZONE / TINS SECTION FOR-OFFICIAL USE ONLY: PERMIT APPLICATION_CHECKLIST ENCLOSED REQUIRED DATE Enildiri- Permit Fillf, 3 nilt Fee Pnirl Tvr of CnnetrnrtiDn' -- Nmv C nyistriirtinn Rernnrlelin2 Interior -- --- _-- Arlrlitinn EYic_ t to I3>>i ld�ii�_I�3us_h�.r1.i it l_e_cL•— ------- -––------------I------ -------- ---------- _ ----- 3 ----------- THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP LICATION: Approved as presentedfbased on information presented !� , i�s nk J/� _� oV Denied as presented: i – r Special Permit and/or Site Plan Required under: § PLANNING BOARD ZONING BOARD Received & Recorded at Registry of Deeds Proof Enclosed Finding Required under: § )N,/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 4' =rom roval-Bd of Health Well Water Potability-Bd Health Conservat' Cornmiss. �op Signature of Buildin ector Date NOTE:Issuanoa of a zoning permit does not relieve inn applioant's burden to oompty with all zoning requirements and obtain ail required permits from the Board of Health, Conservation Commisslon, Department of Public- Works and other applioabie permit granting authorltles.