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10. Do any signs exist on the property? YES NO `S,
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES Nd
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATTON.
This col— to be Ej.1 ed is
by the 2MLI ;ng Dcpnrtmeat
Required 1
:E:xisting Proposed By Zoning
Lot size 3 z Ll P EE X C&D
�/OIUJES
Frontage 7 G/j tue_e p�t go
Setbacks -frnnt 40
- side L:f R: /00 L: /S R: l5-
C 6 Hictfe - rear
Building height LOlzIIV UAj r
Bldg Square footage
%Open Space:
(Lot area minus bldg
1 &n?�'ed F3i
±n i 3 N0 0 3 c,- o 1/070
# of Parking spaces 4 J_ n < /_'_ „ A i Lt. i
! I 1 a--A a Vfl— Irt
f 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 know dg .
t ff
DATE: ! �� APPLICANT's SIGNATURE t
NOTE: la-sunn e o a zoning permit does not relieve an applid nt'a burden to oompty wlt17 all
zoning requirements and obtain call required permits from thd E3oard of Health, Cohservatior
Cornmisaton, Department of Publio Works and other applloable permit granting authorities.
FILE #
J x File No. r/
z09ING PERMT T APPLI CAT20N (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: J e[e hone:
2. Owner of Property:
Address:-6-30 f j21-iAj� Sl�— [ FEg Telephone:
3. Status of Applicant: Owner ontrad Purch r� Lessee
Other(explain): y-
4. Job Location: l
Parcel Id: Zoning Map# 3S- Parcel# 09 District(s): It 4
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property �/ A- /(-f- ir/ r( ( -,
6. Description of Proposed Use/Wo roject/Occup )n: (Use additional sheets if necessary): _
7. Attached Plans_ Sketch plan Site Pfan�� Engineered/Surveyed Pians
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.'
S. Has a Special Permit/Variance�ver been issued for/on the site?
NO
CE) "; ,N-C � YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO ON'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-2006-0079
APPLICANT/CONTACT PERSON MCCUTCHEON DAVID J
ADDRESS/PHONE 263 SYLVESTER RD (413)587-4570()
PROPERTY L G N S P
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FO LLED OUT r,
Fee Pal
Building Permit Filled out
Fee Paid
Tweof Construction: ZPA-DUPLEX
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 AC/T4ON HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION P TED:
Approved Additional permits required(see below)
PLANNING BOARD PERMJT DV^TTIRED UNDER: § Z / 2 - lam+ f�-
Intermediate Project:_ _Site Plan AND/OR Special Permit with Site Plan
Major Project: Site Plan AND/OR Special Permit with Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance*
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
cept;C e r.r royal Board of Health Wa11 Water Pntahility Rnnrcl of Health
Permit from Conservation Commission Permit from CB Architecture Committee
Permit from Elm Street Co 'ssion
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.
*Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact the Office of
Planning&Development for more information.