25C-074 (3) t
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 b�
IF YES,describe size,type and location:
11 . ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED Du.E TO
LACK OF INFORMATION.
This COluz= to be filled in
by the Funding Depnr tmeat
I Required
Existing Proposed By Zoning
Lot size
Frontage
Setbacks - frnnt
- side L: R: L: R:
- rear --
Building height
Bldg Square footage
%Open Space:
(Lotarea minus bldg
&Paged parkingi
# of -Parking spaces
#
of Loading Docks
Fill:
-(volume -& location)
13 . Certification: I hereby certify that the information contained her in_
G is true and accurate to the best of my knowledge. ► �.�T"�
DATE: - APPLICANT's SIGNATURE
NOTE: Wouanoe of a zoning permit does not relieve an applioa s burden to oom ittal all
zoning requirements and obtain all required permits from the Board of Health nserrvtation
Commission, Department of Publio Works and other applioabte permit granthi6 authorities.
FILE #
f
JM Q i9:)o
File No. i 1
OF BUILT
E _ ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: `�/l�}}Rk 'M/k�►�� �►M 'KS471�
Address: (S 'DEFY AvEt-�UC-, NGMi4MPi UN, MA _Telephone: � ►3 5��� t (o s�
2. Owner of Property: klAt ZiC 4 1�lPrKil�f i Y►'l l D N
Address: 15 'DAB AVEOut- NZiHAtL,ITITW W Telephone: 41'3 -16134
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: n—, �7�
Parcel Id: Zoning Map#_ 5e Parcel# L/ District(s):
(TO BE FILLED IN BY THE 6UILDING DEPARTMENT)
5, Existing Use of Structure/Property Q
6. Description of Proposed Use/Work/Project/Occupabon: (Use additional sheets if necessary):
Of,Je CMA& au 1-5+ 'Tt.00 R k7 ?94"-F OF tjO US'f TO 3 E US Cb FOL
C �ft1` t�JiZl'Tl1.3 (�}l �'S iy1� r tv l.-L- JVZEi rff 6-juk - i WCEL
'�O tn3 t t
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/Vadance/Finding ever been issued for/on the site?
NO DON'T KNOW � 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)
t r VM J 1998 + '
i..,
Date Filed _ e File No.
Ya(REGYOII.OF HOME OFFICE/OCCIIPATION (§10.2 & 11.11)
With the Building Inspector
1. Name of Applicant: �L X� l
YL�Q rj dim (IMA Ce ti NVtX lNE J I m l R Snnl>
Address: � � �V��J(�r N��TN �ibN M Telephone: 'y i� - 5g(� - i G S"}
2 . Owner of Property: f\A(V14-- MAx IP4G j i M 6P601,1
Address: 15 D,ky p�urNVc , �1ciLi+t�tn� oN Mai Telephone: 413- 5g6_ 1 (o S-a-
3 . Status of Applicant: ^-4 Owner Contract Purchaser Lessee
Other (explain: )
4 . Parcel Identification: Map #;��I Parcel '4
Zoning District(s) (include overlays) , ,, 4
Street Address_
5. Narrative Description of Proposed Home Office: (Use additional sheets
if necessary) ONE P opv%n 0" 19 AT DP HDOsc 7'0 i�C US£V)
'F iZ
6. Is this a legal residential building? YENO
7 . Will there be an employee/owner who doesn't live in the home `DES eIO�
8 . Will you ever see clients or customers at your site? YE NO
How often r to
For what purposes fcr Creet�Civ� inlet+ wrork5kc
9 . Will there be any signs for the Home fice? YES NO
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? YES NO
11. Will there be any outdoor storage of materials? YES N
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) ? YES 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: Applicant's Signature:
�;iltie N
- - - - - - - - - - -
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
PROVAL EXPIRES ON DECEMBER 31 OF THIS YEAR AND MUST THEN BE RENEWED
Denied as presented--- ason: �p !Z ® Vn 1
Signature of ding Inspec or Datd e
NOTE:Issuance of a permit does not relleve.an applicant's burden to comply with all zoning roViremonts and obtain all required permits
from the Board of Heattl%Conservation Commission.Department of public Works and other applicable permit granting authorities.
it
! FILE f
919% r
F
APPLICAN ONTACT PERSON:X
or Buiup,.., pRESSre NE:
PROPERTY LOCATION: // a-41,
MAP 14?15a PARCEL:-- 01 ZONE
TINS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZnNTNG. FORM En
]3rri}riir Prrmit F111rri nrrt
Foe Pnid
T-ypp of X11nStnrrtin11' - ---- -- -
New CnnCtrlrftinn ___ �
--
_ A[1 rl i 1�1-D f n � x_iSti r)•n �_ __-
I3uiltiiu�J.�us1i�r.-I.ii�rri• --- -- ------- --
-
3
THE FOLLOWING ACTION HAS BEEN Tr%,h-EN ON THIS APft,1CAT1W
Ap'proved as presented/based on information presented
k'--'Denied as presented:
Special Permit and/or Site Plan Required under:
PI.ANNINGBOARD _�ZONINGBOARD
Received & Recorded at Registry of Deeds Proof Enclosed
Finding Required under: § NN/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:
Curb Cut from DPW Water Availability Sewer Availability
,`.
'ptirrApproval-Bd of Health Well Water Potability-Bd Health
Permit from Conserva ' Cods ' n
Signature of Buildingkfector bad
NOTE:Issuance of a zoning permit does not relieve an applicant's burden to oompty with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Public Works and other applicable permit granting nuthorlties-