24D-320 (23) 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.
This colmm to be filled is
by the Banding Department
Required
Existing Proposed By Zoning
Lot size -Z 41
I
Frontage
Setbacks _ c�+''�`'( a-
- side L: �� R: 6 L: 5 R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&paved parking%
# of "Parking Spaces 0
f of Loading Docks O
Fill:
{vol-ume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my know e.
DA'Z'E: /V'V , Zoe APPLICANT's SIGNATURE
NOTE: lasuanoe of a zoning permit does not relieve an appiioants burden to oompty witl .jpl
zoning requirements and obtain all required permits from the Board of Health, Conservt+tio
Commission, Department of Publio Works and other applioable permit granting authorities.
FILE #
L NOV - 4 2004 Fi1e No.,���� y
� �, ��� G ERMIT APPLICATION (§10 . 2)
DEPT.
TYPE OR PR2NT ALL Ili FORMATION
1. Name of Applicant: Qt- (l�l(� z s,4�7L/i`'
Address: 26 f k 4✓'1 /7-tO Telephone: ( — i 2 L I
2. Owner of Property:
Address: Telephone:
3. Status of Applicant: -- owner Contract Purchaser Lessee
Other(explain):
4. Job Location: 4 4 Oay"' 14.L✓-
Parcel Id: Zoning Map# Z— Parcel# 3Z`3 District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupabon: (Use additional sheets if necessary):
_n
uLA tLtl Z10 X yQ 70-u o- CAtL 6A--XAGk
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 PermitA/ariance/Finding ever been issued for/on the site?
NO DON'T KNOVV 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 'Z V 4- Page Ll I t and/or Document#
9. Does the site contain a brook, body of water or wetlands? NO V"" 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-2005-0064
APPLICANT/CONTACT PERSON Oliver Iselin
ADDRESS/PHONE 36 Service Center (413)584-1224
PROPERTY LOCATION 88 ROUND HILL RD
MAP 24D PARCEL 320 001 ZONE URC
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM F LED OUT
ee ai
Building Permit Filled out
Fee Paid
Typeof Construction: ZPA-CONSTRUCT 20 X 40 DET 4 CAR GARAGE
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 F LOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF9ftMATION PRESENTED:
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: §
Finding Special Permit 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 Commis ion
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.