03-008 (5) File No. 9
ZONING PERMIT APPLICATION (,§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: V �►'�-/-J ( �u� iy
Address: zf r7� t✓UL('�`� n'I P;>+ v2 ,22� • Telephone: 6L3)
2. Owner of Property:
Address: �{ '7/ LOLt'S �� t�/�1i ��z� Telephone: 6 1 Sj S—P&
._L'r7yy9, t-'7 7v
3. Status of Applicant: V Owner Contract Purchaser Lessee
Other(explain):
1� J
4. Street Address:
Parcel Id: Zoning Map# Parcel# District(s): /�-�`c !
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property n A I- ! ;iGt� a'/
61 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
i3 C v S 0
Y47-IL!j 011 vz-T- n.ter v c 4+` 7-7 e'S�i
L°c�Li.USc C ✓iU G� /11V_0 "--7L72 S y COA.,s "`Ti9- r7 L:,-V _
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 PermitlVariance/Finding ever been issued for/on the site?
NO y� 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)
Y6 T
C�#- )J4 7 jk ,5'-
A a
..16
0 t
Date Filed �a L & a File No.
REGISTRATION OF HOME OFFICE/OCCUPATION 810 . 2 & 11. 11)
With the Building Inspector
1. Name of Applicant: j/_
Address : y-q/ L-0 Telephone: ('t�7 s:t
G --P/, 7
2 . Owner of Property:
Address: �; c�v��-s �� -D, Telephone: /V,
3 . Status of Applicant: p,-'Owner Contract Purchaser Lessee
Other (explain:
r'
4 . Parcel Identification: Map # , Parcel # `i
Zoning District(s) (include overlays)
Street Address �%/7 ALES "i(t .b ' 7{
5 . Narrative Description of Proposed Home Office: (Use additional sheets
if necessary) ��„�� `zc>c , /� . E- �� r -� r. ,� ✓� L > ?�,�;
?r y
Lb 77-,4
/Z
6. Is this a legal residential building? �Y k) NO
7 . Will there be an employee/owner who doesn't live in the home YES IqVo-)
8 . Will you ever see clients or customers at your site? YES: NO
How often °Z - 3 Z-,z/ !,2 --iv
For what purposes T,irr ��c- C� �C/-f/.v�
9 . Will there be any signs for the Home Office? x/-4 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
11. Will there be any outdoor storage of materials? YES L_NO,
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: c-
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: V Applicant's Signature:��
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
APPROVAL EXPIRES ON DECEMBER 31 OF THIS YEAR AND MUST THEN BE RENEWED
Denied as presented-- eason: T.� - I,
Sign u e u di g Inspec or Dat
NOTE Issuance of a permit does not roileve an applicant's burden to compty 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 authorities.
( Ll
FILE #
APPLICAA/CONTACT PERSON:
ADDRESS/PHONE: a
PROPERTY LOCATION:
MAP PARCEL: ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
NICLOSED REQUIRED DATE
ZONING FORM FTT,T,VD
Fee Pnid
C,
Addition to Existing
3 Sets of Plqnq /Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION'
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:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
!Permit from Conservation mmission
Signature of Building Ins r 15 a{e
NOTE: Issuanoe of a zoning permit does not relieve an applioant's burden to oompiy with all
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commission. Department of Publio works and other applioable permit granting authorities.