03-007 (5) arayl'
" 002�6��
Date Filed File No.
ZONING PERMIT APPLICATION (510. 2)
1. Name of Applicant: C� J
Address: f S O K Telephone:_.5-22: -LPo 6
2 . Owner of Property: . L.I./ 4 � 2.
Address: - Telephone:
3 . Status of Applicant:_,,k Owner Contract Purchaser
Lessee Other (explain )
4 . .parcel Identification: Zoning Map Sheet# ��arcel#�_,
Zoning District(s) (include overla )
_ Street Address
Required
5.
Existincr Pro nosed by 2'ahips'
Use of Structure/Property v tit lci^n v�� n crtt
(if project is only interior work, skip to #6)
Building height
tB1dg. Coverage (Footprint)
Setbacks - front
- side L: R: L: R:
- rear ,
Lot size A /Sg
Frontage-
Floor Area Ratio
. oOpen Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6. Narrative Description of Proposed Work/Project: (Use dditiona sheets
if necessary) cDry LoT;:1 - ?F::L-Ae, Wt-
ti
7 . Attached- Plans: Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
Date: Applicant Is Signature:
THIS SECTION FOR OFFICIAL USE ONLY: +
Approved as presented/based on information presented
as presented--Reason:
Ftarm, it and/or Site Plan Required
nd g Re ed: Variance Required; _
gnatur -0f u lda ate
NOTE: issuance of a zoning permit does not rellove an applicant's burden to comply witit all zoning requirements and obtain all required permits
from tho Board of Health,Conservation Commission,Dopartmont of Public Works and otlior applicable permit granting authorities.
FILE it
' 383
APPLICANT/CONTACT PERSON• ��' -
ADDRESS/PHONE: �? -
PROPERTY LOCATION:
MAP PARCEL: ~j ZONE
THIS SECTION FOR-OFFICIAL USE ONLY:
PERK UT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM MLED OUT
Fee Pn if]
RTyilrfing Peranit Filled nut
Ep�Paid
1
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION:
Approved as presentedfbased on information presented
v Denied as presented:
zcial Permit and/or Site Plan Required under: §J• L. �f. `�F
_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 Com
X_
Signature of Runng r Date
NOTE:lasuanoe of at zoning permit does not relieve an applloanYs burden to comply with all
zoning requirements and obtain all required permits from the Board of Health, Conservation
Commission, Department of Publio Works and other applicable permit granting authorities.