25A-109 (14) 10. Do any signs exist on the property? YES NO V '
IF YES;describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO�'Z
IF YES,describe size,type and location:
11 . ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This co7n to be filled in
by the Building Department
Required
Existing Proposed By Zoning
Lot size C` Q
�J
Frontage
Setbacks
- side L: R: L: R:
- rear
G/
Building height
Bldg Square footage S -f/
%Open Space:
(Lot area minus bldg
&paved parking)
# :of. -Parking Spaces
of Loading Docks
Fill:
:(vol-dme--& location)
13 . Certification: I hereby certify that the information contained herein
rf is true and accurate to the best of my know e.
DATE: APPLICANT's SIGNATURE
NOTE: taauan a of a zoning permit does not relieve an mpplioanta rden to oo p with all
nta and obtain all required permits from the Board of Health. Co sorvaoi zoning requlreme
Commission, Department of Publio Works and other npplloable permit granting authorities.
?. ., FILE if
..a
DEC 2 11995
File No. �3 _
ZONING PERMIT APPLICATION (§10 . 2)
PLEAS TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: '
j A '57 ( _
Address: ��L� / l( Telephone:
2. Owner of Property: j �U�T— � CiU�
Address: l �� f ,/telephone:
3. Status of Applicant: Owner —Contract Purchaser Purchaser Lessee
Other(explain):
4. Street Address:
Parcel Id: Zoning Map#_L-2 Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
,E_ / S UIU 6 1S'Pow it 144,4 f U tVl�-A-TS -7_-Z)
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' ued for/on the site?
NO DON'T KNOW YES IF YES, date issued:
IF YES: Was the permit recorded at the Regis f Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or cument#
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)
t FILE # 0:l.7 l
'PLICANT/CONTACT PERSON:
)DRESS/PHONE: � �� S� 1 1X112
ZOPERTY LOCATION: 33 7 ' 3.7
AP 5 i3 PARCEL: ZONE ,
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DAICE
kidifflng Pi-rmit Filled nut
Additinn to Existing( 126 i
c-f GL v
THF -OLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
A P'roved as presented/based on information presented
e
Denied as presented:
V/S'peci Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Recei�ed&Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § w1ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w1ZONING 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
ermi ro I rvation Commission
�-
1
ignature uildingligW4 ate
NOTE:issuanoa of a zoning permit does not relieve an applioant's burden to oompty with all
_ zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applicable permit granting authorttles.
�s