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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
IF YES,describe size,type and location: 3 _ %� X //B (�wooje_n 1cj j ri&04 on a,( 519 n_s
ho 6e Sal Lto on m'det. ��er7 4' s- c. dau of 7e� pa) Onl,
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This cols to be filled in
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 minas bldg
' &paved parking)
# :pf -Parking spaces
# of Loading Docks
Fill:
_(vol-time--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
_1
DATE: \5 _� �- APPLICANT's SIGNATURE '
J" NOTE: laauanoe of a zoning ~
g permit does not relieve an appiioant's urden to ply with,, 11
zoning requirements and obtain all required permits from the Board of Health, onservatio
Commission, Department of Publio Worker and other appliooble permit granting authorities:
=?` FILE #
Z
File No.
ZONING PERMIT APPLICATION (§10 . 2) u
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: .11ll 4an G I-) (Eng
Address: P— (, Id— -,q Woon,o c(Cef A ..r Telephone: l,5-0 2) 6 7Y ,5 j1&:-
oz B'7
2. Owner of Property: I ' a114 i' ' � M 12M
P D. aox ,
Address: CkL:5:
_L�o
D af±�g'Vn 0/061_Telephone: J g� rJ'9 $6
3. Status of Applicant: Owner Contract Purchaser Lessee
_XOther(explain):��n� c13T i(S� OT ae�I c,na4et Srf� joe� 1"1C��./u1=
4. Job Location: nog n was 5 ewe a ntor`f,aoes'� _ can c� _y_ NUn w a
r
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE 8UILDING DEPARTMENT)
5. Existing Use of Structur rop� .0-vi`f"'
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
1`� one- -c a cyeni
�cLdJed r 2!-10 -y7 LNaln Joie 2- 17- 77 om 7 Fim -h 4,13o p.,�,
7. Attached Plans: X 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/Vadance/Finding ever been issued for/on the site?
NO DON'T KNOW- V 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_X' — 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: 111�9
(FORM CONTINUES ON OTHER SIDE)
FILE # 7 i
a �
ApPLICANT/CONTACT PERSON: '
ADDRESS/PHONE: ) %'` �-
PROPERTY LOCATION: —
MAP PARCEL: ZO
THIS SECTION FORAFFICIAL USE ONLY:
PERNIIT APPLICATION CHECKLIST
c J ENCLOSED REQUIRED DATE
Rnilding Permit Filled nift
Fee paid
>C/1
✓.
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPEICATIOM
Approved as presented/based 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: T m12vr a rM ���r, , ,5))CL�j x c ij
1
Curb Cut from DPW Water Availability Sewer Availability 1
Ford'
Y Iii*tee ("Pane >1
��c Approval-Bd of Health Well Water Potability-Bd Health
!Permit from Conservati ommissio _ Obft�,�t�� 9CP �l
Signature of Building for D e
NOTE:Issuanoe of a zoning permit does not relieve an nppiioanYs burden to oomply with all
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commisalon. Department of Publio Works and other applionble permit granting authorttles.