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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 X NO
IF YES,describe size,type and location: S N-T-rO.e-.N t^F&
11 . ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This column to be filled in
-a'q-Lv l5'T`�"P.�-.1=. " y�. '�;�e j ' by the Building Department
Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg
&Paved parking)
# of Parking Spaces
t of Loading Docks
Fill:
-(Volume--& location)
13 . Certification: I hereby certify that the information contained herein
G is true and accurate to the best of my
ledge.
DATE: -{,o APPLICANT's SIGNATURE U:X
NOTE: IsaWn-nida of a zoning permit does not relieve an appli an ur n to oomply wit" all
zoning requirements and obtain all required permits fro on ealth, Conservation
Commission, Department of Publio Works and other applloable permit granting authorities.
FILE #
U
F!FEB
6
File No. p3cP01 t
J
--- _ ,.--ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: fa w-t ?7-0+J 1.-+oars C L"ja �, /f/��►,�o�,L,
Address: P.6, '3 ex Telephone: 5"r r -
2. Owner of Property: i C. A.b ea-r%
Address: Qta� r- fLP-44 t 14 tea ft 'r'r Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
X Other(explain):_ C 14 N ILI'T t--V,(i Q�- + o k l
4. Job Location:
Parcel Id: Zoning Map# 0� Parcel#— District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property tsla(kjz"T"'"I&ice VJ, A t tx,. I,uv=r-
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
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 KNOW YES _ IF YES,date issued: 2 �
IF YES: Was the permit recorded at the Registry of Deeds? +V"'
C*,L 6 T'%
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 ?C 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 #
�fi 1
APPLICANT/C N ACT PERSON
DEPT d � -
:t,.. U,i
PROPERTY„LOCATION:
MAP �� PARCEL: �Sr ZO
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
Ruilffin2 Permit Filled nnt
iFei, PA if]
Addition tnRykfin2
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION-
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: X �It�j �U/ncl%
�1 s U
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
!Permit from Conservati Commission
Z L-
Signature o i g for Date
NOTE:Issuanoo of at zoning permit does not relieve an appiioant's burden to oompty with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Cotnmission� Department of 'Public), Works and other applioable permit granting authorities.