25A-090 (6) 10. Do any signs east on the property? YES NO y
IF YES,describe size,type and location:
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 MUST BE.COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF ,INFORMATION.
This Colman to be filled in
by tha Banding Departaant
Required I
Existing Proposed By Zoning
e t2 r(f
Lot size � 'I
Frontage b(p j
Setbacks -frnnt
- side L: R: L:
t
- rear
Building height
Bldg Square footage
2.2 q
%Open Space:
(Lot area minus bldg
&Paved Parkingi
# of -Parking spaces a
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 knowledge.
DATE: 3 �I
4( APPLICANT's SIGNATURE
NOTE: iss anoe of a zoning permit does not relleve an applioant's bu tC6 Comply with all
zoning requirements and obtain all required permits from the Board of health, Coinservtstion
Commission, Department of Public, Work= and other appiioable permit granting authorities.
FILE it
File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: i c'-o YI Q A4(j Pi (7-f-
Address: r-001( -
U 1( - Ave . Telephone: Ll J3 - -03 g
2. Owner of Property: Vl Y la- Yl OVa WC(� ,� Z1C0
Address: S 2 M-A'- Telephone:
3. Status of Applicant: ✓Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: 0 UK 1-1,9 m'0-
Parcel td: Zoning Map# '� Parcel# c') District(s)•
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property Y I f�ym e-
6. Description of Proposed Use/Work/Project/Occupaton: (Use additional sheets if necessary):
0m- mom (r) Y Q%lku 1ol fl uSPd 4v
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/Variance/Finding ever been issued for/on the site?
NO DON'T KNOl1Ij,� 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)
0 2004' '
Date Filed ,: --
p�lA n File
' _ 9
REGISlRA.TION IiDRE O1FICE/OCCUPATION (510.2 & 11.11)
jt_h` th-• uilding Inspector
1. Name of Applicant: C. 1 Movre
C o /3 STy 6:39-Address:
2. Owner of Property: ."�J,10'- U f 1 ✓j C� D UB ( rGZ yC�
Address: t�Q bo Teleph'o .e:
3 . Status of Applicant: , owner Contract Purchaser Lessee
other (explain: )
4 . Parcel Identification: Map "JJA- , Parcel f ,
Zoning District(s) (include overlays)
Street Address
5_ Narrative Description of Proposed Home Office: (Use addition l sheets
if necessary) V VY1 P1 0 U LAJ {)
n or o yvu toK wla kj k1
6. Is this a legal residential building? (YE NO
7 _ Will there be an employee/owner who doesn't live in the home YES CND
8 . Will you ever see clients or customers at your site? E_S NO
How often O)qCP 0- l 411 n-
For what purposes V GL
9. Will there be any signs for the 110me Office? YES d13
10. Will there be any goods sold from the premises or any sale of
goods stored on premises, either retail or wholesale, or any
display of goods on premises? (Y E4 NO
11. Will there be any outdoor storage of materials? YES <100
12 . Will your use be totally within a building and not cause any
outward manifestation (including traffic generation, parking
congestion, noise, air pollution, and materials storage) ? NO
If No explain:
13 . Attach Plans (if applicable)
14 . Certification: I hereby certify that the information contained herein
is true and accurate. I understand that if any information is incorrect,
my permit is null and void and I may be liable for non-criminal fines and
criminal and civil actions .
Date: `3 1c;22/6� Applicants Signature:
—THIS SECTION FOR OFFICIAL USE ONLY:—
Approved as presented/based on information presented
APPROVAL EXPIRES ON DECEMBER 31 OF THIS YEAR AND MUST THEN BE RENEWED
Denied as presented---Reason:
Signature of Building Inspector Date
NOTE:lssuanoo of a pefrtrit dos:not rollove an applicant's burden to compty wfth all zoning roquirements and obtain all roqulrod pormitz
from tho Board of Hoatth.Consorvation commission, Departmont of Public Works and othor applicable pormit granting authoritlos.
FT �
File#MP-2004-0122
APPLICANT/CONTACT PERSON MUNROE VICTORIA
ADDRESS/PHONE 38 COOLIDGE AVE (413)584-0393
PROPERTY LOCATION 38 COOLIDGE AVE
MAP 25A PARCEL 090 001 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Buildiniz Permit Filled out
Fee Paid
Typeof Construction: HOME OFF/OCC REG-MAKING SOAP
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 ACT N HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION PRES TED:
Approved 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
ZONING BOARD PERMIT REQUIRED UNDER: § D 12- M{en
Finding Special Permit L-1� Variance*
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
Permit from Elm Street Commission
...,tea
Signature of Building Ofticial 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.