37-065 (15) File No.
ZONING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: C&\- Ckj C)
Address: &kl r I r Telephone: ''( 13 5'1103 ( l1�
2. Owner of Property:T_�,�lrti R;1P Jc�Dj��11
Address: �r L(7� 1°�i (� Telephone:
k- �
3. Status of Applicant: _Owner Contract Purchaser Lessee
Ofither( (explain):
4. Job Location: 1 lidI��'� ��G�� r I
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property ff\mllfu tom&&Ca—
6. Description pf Proposed Use/Work/Project/.Occupabon: Use additional sheets if necessary l:
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:
1F 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 Con mission?
Obtained I o^r C0',,5� 1 D
Needs to be obtained date issued:
(FORM CI NTiNUES ON OTHER SIDE)
10. Do any signs exist on the property/? YES_ ____ NO -
IF YES,describe size,type and location:�C c I G, L�I'n �Ils inUA"P- A''S
G C SICA V\S' S IAA �' ICcti ' �'� (C�,2 .1�`Z, In '�4V l(nL:d ✓IZ�LS
ar� kus�- v\rJv T-, ' �rrt;(,k�S VL�Z' YY)G�^ j�-L
Are there any proposed changes to or additions of signs intended for the property?YES €o!o
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED BITS TO
L}CK OF INFORMATION. (_ n
C 2
LOA Y 1 pp,��'drrl `W_V 1 C) �/i�[L� O Y eoZx� to be fil2ad i
✓�p�� ll. � - rv"n -C �� GL1�TlGU�� &�err4 /lQ Y caow- CC cokc-sin by t*e B-iliag
'Required
Existing Proposed By ZoningI
Lot size
Frontage
Setbacks -front
4
- side L: R: L: R.
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus b1dl
&paved parj!L,2gN I
# of Parking Spaces 'Sav"R
Ichn acc(r5s rck
f of Loading Docks Y-)cy�-L
Fill:
{volume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
APPLICANT's SIGNATURE
mo a E: of a zoning permit doee not relieve nn applim :s L;terden to oornp y W AEI
coning regulrement� and obtain call required permits from t a aamrd of Health, Gar:se��tiaes
Commission, Department of Public War" and other applloabla permit. granting auohorKles,
FILE if
a kf l
RFGIST NTION OF O_F-?'CE/OCOurz^_ON (§10- 2 & !I- I!)
�- �I 't�n` She Building Insaec for
I
1. ?dame o= --_ � 1lcant: � �-� � �. 1
Address: -S;a I;, Tr j Telephone:
2. 0 KTn er o f Property: �l �� `L Joe ' jeJ4
Address: �iX ES �G�c� 1.�� Tr Telephone: (�- S�'?-•
� . Status of ADpDJ_ nt: Owner Contract nurCliaSGr Lessee
Other (e _plain:
4 . Parcel Identification: M.ap r Parcel
Zoning Di Strict(s) (include overlays)
Street Address ( aC.� t, f
5- -'\Tarrati%,e Descripti n of Proposed Home Office: (Use additional sheets
if n cessary) ���V.-Ave 1 � SSGaS 1
S c•- n
6- Is this a legal residential building? N
7 Will there be___an_._e_mp_o ee ow-ne who do`sn d)
"' you eve_ see clients customers o live ,n the home y"S N.O
r
S. - , 11 r e i�/,r � ers at VOur site? �rES ISO
±-ow often 10 ej2,k_
For writ purposes � , ,;-6
9 . Will there be any s gns for tine doze Office? E NO
00. Will there be any QOods sold from t7na premises or any sale of
goods stored on pre-m ses, either retail or % holesale, or any
display of goods on premises? YES T
i 1- Will there be any outdoor storage of _*aa ter?als? YES 2�0
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) ? yFS" NO
if NO e}-plain:
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 _
r
Date: ' applicant's Sig-nat_1?re: ��
- - - - - - - - TI3 SECTION FOR OFEICIzI, IISB 0?1T�Y: - - - - - - - -
Approved as presented/based-on information Dre°sented
P.?PPROVA._L EXPIRES ON DECE`H ER 31 OF T--,Is yrFz-p, -ND Y-UST THEN BE RENT ED
Denied as presented---Reason:
Signature of Building Inspector Date
NOTE 1x=uzrrpo of it parrnr doaz not roilovo an app[ic-n c EUrden to comaty w;th aIf zoning rcCFAromon.a and o-b4A1n rII roauirod p0,—,, 3
from LIK Board of I-iortth,conzarvatSon Commission, Dopartmont of Pubtic-worf=and oL`ior applicable pormit granting author.ti—
4
File#MP-2008-0087
APPLICANT/CONTACT PERSON JEWETT JOSEPH&KIRA
ADDRESS/PHONE 126 BLACK BIRCH TRAIL (413) 582-0346 Q
PROPERTY LOCATION 12611LACK
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid
Typeof Construction: HOME OFF/OCC-VIOLIN LESSONS
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 FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFORMATION 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: °��2-
Finding Special Pen-nit 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 Commission Permit DPW Storm Water Management
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.