17A-055 Date a d File No.
DEFRt�CY' 6TRATION `OF i HOME OFFICE/OCCUPATION (§10.2 & 11.11)
With the Building Inspector
1. Name of Applicant: llu fl
Address: Telephone: 3 SR-76-9
2. Owner of Property:
Address: Telephone:
3 . Status of Applicant:-4Owner Contract Purchaser Lessee
other (explain: )
4 . Parcel Identification: Map f/7i¢ , Parcel
Zoning District(s) (include overlays)
Street Address
5. Narrative Description of Proposed Home Office: (Use additional sheetE
if necessary)
ZW, )e C'�13 tJ,'1C
6. Is this a legal residential building? YES NO
. 7 . Will there be an employee/owner who doesn't live in the home S NO
8 . Will you ever see clients or customers at your site? YES NO
How often y. u
For what purposes ��,4AtA 0/ Inc, h f 1A
9 . Will there be any signs for the Home Office? 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
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 ancc
criminal and civil actions.
Date: Applicant's Signatu�e: �
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 RENEWEL
Denied as presented---Reason:
Signature of Building Inspector Date
NOTE:Issuance of a perrnit doe:not relleve an applicant's burden to comply wfth all zoning requirements and obtain all required permit
from the Board of Hoa4th.conservation commission, Department of Public Works and other applicable permit granting authorities.
10. Do any signs exist on the property? YES NO k
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO X
IF YES,describe size,type and location:
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This colu= to be fi22ed in
by the Bnildiny Department
Required
Existing Proposed By Zoning
Lot size , S94 Acn2s
Frontage iso 0:klsc = dWR
Setbacks - frnnt
►^�'lr� - side L: R: L: R:
A6J
- rear
Building height 2S V+
Bldg Square footage
%Open Space:
� (Lot area minus bldg
l�J;re� &paved parking%
# of Parking Spaces Z plus voc�j $ tom
f of Loading Docks NIA
Fill:
�+C ' {vol-ume--& location)
13 . Certification: I hereby I certify that the information contained herein
is true and accurate to the best of my knowledge.
DAVE: 7/s27 h9 APPLICANT's SIGNAT
e
NOTE: Issu noe t a zoning permit dos not reliev an applicant's burden to oomply wit4 ell
zoning requlramanto and obtain all required permits from the Board of Health, Conservation
Commission, Department of Pubilo Works and other applicable permit granting authorities.
FILE #
j „�t
Vim.,■'
1 File No
ZONING PERMIT APPLICATION (§10. 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: zm oe� 'ka Ap&-�
Address: �� &14,- Rd Rov-rku Telephone: -7
2. Owner of Property: SR kv�-t
Address: Telephone:
3. Status of Applicant: X Owner Contract Purchaser Lessee
Other(explain):
4. Job Location: /-73 Rj r^i 4e K/�cJ
Parcel ld: Zoning Map# /7!7 Parcel# s.' District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property 2- car y,exnt
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
et r> aA-a/ Y—G GItssses -ev eA. NPw o/jj
a&( P^Vi tee.. /
4Ca71lr. e i -b C-
3 3 tl . ,)lk -,7' L e �cl
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/Variance/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 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:
(FORM CONTINUES ON OTHER SIDE)
File#MP-2000-0014
APPLICANT/CONTACT PERSON RAHM LINDA K
ADDRESS/PHONE 173 BRIDGE RD 584-7627
PROPERTY LOCATION 173 BRIDGE RD
MAP 17A PARCEL 055 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ONING FORMfILLED OU
�-c
Building Permit Filled out
Fee Paid
Typeof Construction: HOME OFF/OCC-MARTIAL ARTS SCHOOL
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:
Approved as presentedibased on information presented.
Denied as presented:
1/ Special Permit and/or Site Plan Required under:
PLANNING BOARD _LI-11, 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 Board of Health Well Water Potability Board of Health
Permit from Conservation Co s ' n
Signature o wilding 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.