36-132 (2) 10. Do any signs exist on the property? YES No V
IF YES,describe size, type and location:
1
Are there any proposed changes to or additions of signs intended for the property. YES NO t�
IF YES, describe size,type and location:
11 . ALL INFORMATION MIDST BE COMPLETED, or PERMIT CAN BE DENIED DUE To
LACK OF INFORMATION.
This coiumm to be filled in
by the Building Z?ePartment
Required
Existing Proposed By Zoning
Lot size
Frontage / f �e
Setbacks -.front 5 - D
- side
L: R j_ L• �f
- rear 'ry, ,A.�.-
Building height
Bldg Square footage
%Open Space: / `�
(Lot area minus bldg -^�- +
' &paved pax-king) o C�
# :of marking spaces
,# of Loading Docks
Fill:
-�(vol-ume--& .location) r
13 . Certification: I hereby certify that the information contained herein
G, is true and accurate to the best of my knowledge.
DAVE:_ s-�•-.. e'�' -- �' ApPLICANT's SIGNATURE
NOTE; Issuance of a zoning permit does not relieve a apptioants burden to oompty with sli
zoning requlrensq--nts and obtain all required permits front the Board of Health. Conservation
Commisslon. Department of Publio Works and other applicable permit granting authorities.
FILE ,
.
'
��..T Ai
File Nu'
ZONING PERMIT APPLICATION (§10 , 2)
PLEASE OR P=T ALL INFORMATION
1. Name of Applicant:
_
Address: Telephone:
-- Owner of Property:/_'i-
Add Telephone:
3. Status ofApplicant: {}*ner Contract Purchaser Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map Parcel# District(s):
(TO BE FILLED IN BY THE 8U|LU|N6 UEP8M|K0EN |7
5. Existing Use ofShoduro/P rope rty
6. ��
- if--
To
7. Attached Plans: Sketch Plan Site Plan oered/Sun/oyodP|onu
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has Special permiUVahunoe/Finding ever been issued (onhn the site?
NO DON'T KNOW YES |F YES,date issued:
(FYES: Was the permit recorded ut the RegisbYofDeeds?
NO DON7 KNOW YE
IF YES: enter Book Page and/or Document
A. Duon the site contain a brook, body of water or wetlands? N DON'T KNOVV YE
IF YES, has a permit been orneed to be obtained from the Conoen/uUoh `Commission?
Needs tubo obtained Obtained date issued: _
(FORM CONTINUES ON OTHER S\OB
�
FILE # l L
I /
AgLIC iNT/CONTACT PERSON:
ADDRESS/PHONE: ; d -
PROPERTY LOCATION:
MAP PARCEL: ,L:� p- ZONE
THIS SECTION FOR.OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
70NING FORM FH.T,FD OUT
e�
9
ti
T OLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: :k
Approved as presentedfbased 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
Permit fropeConsem Co on
d
Signature of Building Inspector Da
NOTE:lssuanoe of a zoning permit does not relieve an applioant's burden to oomply with all
_ zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities. _
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