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17A-248 (2) City of Northampton Massachusetts _. � pTO Office of Planning and Development City Hall • 210 Main Street Northampton, MA 01060 • (413) 586-6950 SP 3 0 19 FAX(413) 586-3726 •Community and Economic Development •Conservation•Historic Preservation DEPT OF BUILDING INSPEC •Planning Board•Zoning Board of Appeals NORTHAMPTON MA O1GG •Northampton Parking Commission TO: Anthony Patillo, Building Inspector RE: Permit application FROM: Laura Krutzler, Board Secretary/OPD DATE: 44-�C� ve, /q� Would you please review and return the enclosed application before the Planning Boar ,A peals eeting scheduled for 04 7 so that we can advise the Boards of any concerns you may have. `r Thank you. -THIS PLAT NOT FOR RECORDING PURPOSES- 78.3 '+ Plan Book 69 Page 50 Lot #22 _H o _H U - N Cy 16 20 ' #98 77.9 ' + M Lake Street To: The Springfield Institution For Savings & The Minnesota Title Insurance Co. I HEREBY REPORT THAT I HAVE EXAMINED THE PREMISES, AND BASED ON EXISTING MONUMENTATION, ALL EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON THE GROUND AS SHOWN AND THAT THE BUILDINGS ARE ENTIRELY WITHIN THE LOT LINES. I FURTHER REPORT THAT THE PROPERTY IS NOT LOCATED IN A FLOOD PRONE AREA AS SHOWN ON FEDERAL INSURANCE MAPS FOR COMMUNITY NUMBER 250167 DATED: July 29, 1991 -NOTE- THIS PLAT FOR SMORTGAGE LOAN PURPOSES ONLY Q SURVEYOR: AND DOES NOT CONSTITUTE A PROPERTY SURVEY ./� -MORTGAGE LOAN INSPECTION PLAT- 14 of Northampton, Massachusetts Prepared For RICHARD J. Edward M. & Anne M. Kocinski r w LABARGE,sFt Scale: 1 "=40 ' #34605 RICHARD J. LaBARGE SR. Usuou REGISTERED PROFESSIONAL LAND SURVEYOR (UNIT C-9) 1 STADLER STREET-BELCHERTOWN,MA 01007 �sSG 2 1941 ; � Date File File No. REGISTRATION OF HOME OFFICE/OCCUPATION (§10.2 & 11.11) with the Building Inspector 1. Name of Applicant: M A>z FN T. bAOw 1`4 Address: 9$ LAKE' ST• FI.PMWC Telephone: 5$(, -C)901 2. Owner of Property: - 6ATnE AS A8OVIE Address: Telephone: 3 . Status of Applicant: ➢C. Owner Contract Purchaser Lessee Other (explain: ) 4 . Parcel Identification: Map # 17A , Parcel # 2-4J3 , Zoning Districts) (include overlays) L4 AS Street Address 618 LAY-6 ST - FLO FLEWC.G 5. Narrative Description of Proposed Home Office: (Use additional sheet: if necessary) A Rc)OAA DN `M6 s040AJ 3 X1,.0092 Ole "Y MbUS6 WktCA HA-1 AVEN GONVEn-E'b INM A-Aj heP' 6TU D I O 6. Is this a legal residential building? NO 7 . Will there be an employee/owner who doesn't live in the home YES NQ 8 . Will you ever see clients or customers at your site? YE NO How often p - 3 G 1A ENTS (MONTH For what purposes -M 56X My A<9TW0ILK- 9 . Will there be any signs for the Home Office? YES 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? 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) ? <Zg NO If NO explain: 13 . Attach Plans (if applicable) 14. Certification: I hereby certify that the information contained hereil 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-crimin fines ant criminal and civil actions. Date: 64, � C17 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 RENEWEI Denied as presented---Reason: Signature of Building Inspector Date NOTE: lafuanoe of a permit does not relieve an applicant's burden to oompty with all zoning requirements and obtain all required permit - from the Board of Health,Conservation Commission,Department of public Works and other applicable permit granting authorities. 10. Do any signs ebst on the property? YES NO X 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. n, Thin cols to be filled in Q� by the Bedding Drpnrtmeat Required i Existing Proposed By Zoning Lot size Frontage Setbacks - frnnt - side L: R: L: R: - rear Building height Bldg Square footage %Open Space: (Lot area minus bldg ' &Pared rarking) # of 4Parking Spaces # of Loading Docks Fill: 4 vol-ume--& location) 13 . Certification: I hereby certify that the information co ined herein is true and accurate to the best of my knowledge. DANE: je -:F APPLICANT's SIGNATURE NOTE: Issuance of a zoning permit does not relieve an pplfoanra b en to comp witlp•,a11 zoning requirements and obtain all required permits from the Board of Health. Conservntioc Commission. Department of Public Works and other applicable permit granting authorities. FILE # I' AIJu 2 7 199- File No. ZONING PERMIT APPLICATION (§10. 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: M A IZ E:N T . B JZD W r' Address: '18 LAKE ST o►2t:—rJ E Telephone: 58 6"090 l 2. Owner of Property: " SAME AS ArBO V E Address: Telephone: 3. Status of Applicant: _Owner Contract Purchaser Lessee Other(explain): 4. Job Location: Parcel Id: Zoning Map# Parcel# District(s): (TO E ILLED IN BY THE BUILDING DEPARTME S. Existing Use of Structure/Property 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): ^ R7` 5TL1 D 10 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 ,X YES IF YES,date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW X 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 # J v 1 APPICANT/CONTACT PERSON: ADDRESS/PHONE: PROPERTY LOCATION: MAP PARCEL: ZONE _ Z-f%? r- THIS SECTION FOR-OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FTF,T,FT) ]Ridlding Permit Fillt-d nut Remodelin Interior Addition In Fxistin2 3 i THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION: Approved as presentedfbased on information presented Denied as presented: 0 Chu Special Permit and/or Site Plan Required under: § (�,/(� "� y`'0�5 PLANNING BOARD V ZONING BO RD Cu Ito�£ 'n Received &Recorded at Re istry 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 mission Signature of Building Daie " NOTE:issuanoe of a zoning permit does not relieve an appiioant's burden to oompty with all zoning requirements and obtain all required permits from the Board of Health, Conservation Commisslon, Department of Pubiio Works and other applloable permit granting authorities. Signed Dated and Denied Zoning Permit Application be in harmony with the general purpose and intent of the Ordinance: As a homeowner, I heartily support the general purpose and intent of this Ordinance, and appreciate the scrutiny with which home businesses are assessed in our City. I am pleased to live in a primarily residential neighborhood (there is a casket company at one end of Lake Street), and am proud of the aesthetic appeal of our street. Although I am permitted to display a sign, I do not wish to do so, out of concern that our street remain residential in appearance. In addition, I will be seeing customers primarily off the premises for this same reason. I sincerely care about preserving our neighborhood's charm and appeal, and profoundly believe my art business will not disturb this in any way. F. Explain how the requested use will promote City planning objectives to the extent possible and will not adversely affect those objectives, defined in City master study plans adopted under M.G.L. Chapter 41, Section 81-C and D. I understand from the Northampton Office of Planning and Development that these master study plans only concern the State Hospital grounds and downtown areas. Because our house does not fall within these bounds, this question is not applicable. Also submitted with application (not part of copies): *Check for$120 made out to the City of Northampton -Two Sets of Abutter's Mailing Labels -Three Copies of the Certified Abutters List from the Assessor's Office "8. The hours and frequency of deliveries of products and/or materials shall be expressly stated in the Special Permit issued by the Zoning Board of Appeals." Although I need to accommodate my potential customers hours as stated in question #7 above, I think that UPS and the post office only deliver packages from 9 a.m. to 5 p.m., Monday-Saturday. "9. If said Home Occupation takes place in an accessory structure: A. constructed prior to the date of the adoption of the Ordinance,then said structure must conform to the setback requirements for accessory structures in that District. B. constructed after the adoption of this Ordinance,than said structure must conform to the setbacks requirements for a principal structure in that District." My business will not be located in an accessory structure, nor are we planning to construct one. "10. It shall produce no noise, obnoxious odors, vibrations, glare, fumes or electrical interference which would be detectable to normal sensory perception beyond the lot line." Creating my art and operating my business will produce no detectable noise, obnoxious odors,vibrations, glare,fumes or electrical interference. "11. The portion of any structure utilized for a Home Occupation shall conform to all applicable Fire, Building, Electrical, Plumbing and Health codes." There will be no changes made in the existing structure or use of our house, which already complies with these codes. F. Explain why the requested use will: not unduly impair the integrity or character of the district or adjoining zones: I believe I have demonstrated in this application that my home business will not disturb the integrity or character of the district or adjoining zones. There will be no changes or alterations made to our building, and traffic will be limited to a high estimate of 0-3 customers/month, as I've described. The residential character and purpose of our home will be unchanged with this business venture. not be detrimental to the health, morals orgeneral welfare. My business will pose no threats to the health, morals or general welfare of Northampton, and if anything, will help to support the general welfare by promoting small business. in the occupation except members of the immediate family also residing in such building." As I've stated earlier in this application, I will be the person who operates this sole proprietorship, and the house is my principal residence. I have no employees working for me, either part-time or full-time, and no other person is engaged in the business. "3. It must not occupy more than 40% of the gross combined floor area of the main building, and the accessory structure (if such accessory structure is utilized for said home occupation)." I will be using two rooms in the house for the business: a studio on the second floor of the house and a small office on the first floor of the house. There are three comparably sized rooms on the second floor of our house (one of which is the studio) and on the first floor is a diningroom, livingroom, kitchen, bathroom and a small office. The basement is unfinished. The two combined rooms I intend to use for the business fall well below the 40% limit of the Ordinance. "4. One sign may be displayed advertising the Home Occupation provided: A. it does not exceed one (1) square foot in area; and B. it is attached to the structure next to or on the entryway for said Home Occupation. C. it is not illuminated." I do not plan to display a sign on the premises. "S. Goods may only be offered for sale from the premises if the Zoning Board of Appeals expressly permits it in the issued Special Permit." I am requesting that a permit be issued which allows me to sell my art to 0-3 customers per month, as described in question #7. As I stated, I intend to sell the majority of my artwork to clients at their place of business; however, I would like the flexibility to accommodate those who wish to see a broader selection of work at my home studio on an infrequent basis. "6. All goods sold must be produced or manufactured on the premises." All my art will be made in my home studio. "7. The hours of operation shall be expressly stated in the Special Permit issued by the Zoning Board of Appeals." I would like to be permitted to see customers from 7 a.m. to 10 p.m. on weekdays and weekends, to accommodate the schedules of my potential customers, whose retail establishments are open Monday-Sunday, from 9 a.m. to 5 p.m. I would imagine that they would come before or after their normal business hours, although they may wish to see my studio during their business day as well. to existing buildings: No changes or alterations are planned, other than installing a business line. other community assets in the area: Because there will be no visible signs of a business, I do not anticipate any impact in this regard. D. What measures are being taken that show the use will not overload the City's resources, including: water supply and distribution systems: There will be no change in use. sanitary sewage and storm water collection and treatment systems: There will be no change in use. fire protection, streets and schools: There will be no change in use. How will the proposed project mitigate any adverse impacts on the City's resources, as listed above? There will be no change in our use of these resources. E. List the section(s) of the Zoning Ordinance that states what special regulations are required for the proposed project (Accessory apartment, home occupation, accessory structure, etc.) A Home Occupation Permit is required, according to the attached Zoning Permit Application denial, under Sections 10.10 and 11.11 of the Zoning Ordinance Code, due to the "sale of goods and customers in home." How does the project meet the special requirements? (Use additional sheets if necessary): I have already demonstrated how my request will comply with all the stipulations outlined in ordinance 10.10 in this application (which reiterates the ordinance), concerning the impact of this project on the neighborhood and community. I will therefore respond to Ordinance 11.11, which deals specifically with Home Occupation Special Permit Criteria, applicable portions of which are restated here in bold, followed by my response: "All Home Occupations (as defined in section 2.1) and Special Permits issued for Home Occupations shall comply with the following: 1. It must be clearly incidental and secondary to the use of the building or property for residential/dwelling purposes." The purpose of locating this business on my premises is for convenience and to minimize costs in the start up phase. Our home is our residence, and any business use would be incidental to that main purpose. "2. It must be conducted by the principal practitioner who occupies the main building as his/her bonafide residence, with no more than one other person engaged How will the project provide for: surface water drainage: There will be no change in use. sound and sight barriers: We have an existing 8' stockade-type fence which divides our driveway from our neighbor's driveway, and which completely screens all activity in either building from one another. Any customers coming to our house would be effectively screened from our neighbors by this existing fence (which we own). the preservation of views, light and air. There will be no change in use. B. How will the requested use promote the convenience and safety of pedestrian movement within the site and on adjacent streets? My proposed business will not impede pedestrian movement in any way within the site or on adjacent streets. How will the project minimize traffic impacts on the streets and roads in the area? Our driveway is sufficient in size and length to contain the cars of customers and/or mail trucks (it extends back into our property, where it is bordered the entire length by a fence, and can fit approximately five cars). Where is the location of driveway openings in relation to traffic and adjacent streets? Our driveway opens onto the middle of Lake Street, and there will be no alterations made to it. What features have been incorporated into the design to allow for: access by emergency vehicles: No changes or alterations are planned. the safe and convenient arrangement of parking and loading spaces: Our driveway provides excellent access to a mud room located in the rear of the house, for loading and unloading artwork. provisions for persons with disabilities: Our house is not wheelchair accessible, and since no structural modifications are planned, I do not believe that wheelchair accessibility is a requirement. C. How will the proposed use promote a harmonious relationship of structures and open spaces to: the natural landscape: There will be no structural modifications to our house, and we will not install any visible signs of a business on our property. #7. Describe Proposed Work or Project: I would like to establish an art business in my home, where I would produce artwork and prepare it for shipping to galleries, gift shops and other retailers (I would ship it off the premises at a business like Mail Boxes, Etc.). I would like to use a room on the second floor of my house, which has been converted into an art studio, to produce and package my artwork. A room on the first floor of my house that has a computer and filing cabinets, would be my choice for conducting the "office" activities related to the business. I do not plan to install outdoor signage, store materials in outbuildings on the property, or show any other visible signs of a business being located on the property. No physical modifications need to be made to the building, except for installing a business phone line. A Home Occupation permit was required for two reasons. The first was that I indicated on my Zoning Permit Application that I would have 0-3 customers per month visit my home. My intention is to sell my work primarily off the premises, at my customers' retail establishments, by bringing samples to each customer. However, my guess is that on some occasions, customers may wish to arrange a visit to my home studio to see a broader selection of work from which to choose. I believe the estimate of 0-3 customers per month to be a high number. Another reason a Home Occupation permit was required is that I indicated on my Zoning Permit Application that my artwork would be sold from the premises. As I've described above, I anticipate that the overwhelming majority of my sales will occur at my customers' places of business, but I answered this question affirmatively on the Zoning Permit Application to account for the rare instances when a buyer may wish to visit my home studio to view a wider selection of work. For example, if a buyer were to visit my home, and would like to purchase three of my photo transfer paintings to sell in his or her store, I would like to offer the work for sale to them at that time. If the amount were sufficiently small, they may wish to take it with them; of, if it is a larger amount, have me deliver it to them at a later date. Again, I want to emphasize that I view this to be rare occurrence. 8. Special Permit Approval Criteria. If any criteria does not apply, explain why. A. How will the requested use protect premises against seriously detrimental uses? As I stated in Question#7, there will be no outward signs of a business on our premises. Inside and outside, there will be change in the use of our house that impacts on any of these areas. **PLEASE SEE ATTACHED FOR ANSWERS TO ALL QUESTIONS*** How does the project meet the special requirements? (Use additional sheets if necessary)? F. Explain why the requested use will: not unduly impair the integrity or character of the district or adjoining zones: not be detrimental to the health, morals or general welfare: be in harmony with the general purpose and intent of the Ordinance: G. Explain how the requested use will promote City planning objectives to the extent possible and will not adversely effect those objectives, defined in City master study plans adopted under M.G.L. Chapter 41, Section 81-C and D. 9. 1 certify that the information contained herein is true and accurate to the best of my knowledge.I (or the landowner if I am not the landown gra t Zoni Board of Appeals permission to enter the pr erty to review th' Date: Applicants Signature: Date: Owner's Signature: (If not the same as applicant's) i 4 **PLEASE SEE ATTACHED FOR ANSWERS TO ALL QUESTIONS*** provisions for persons with disabilities: C. How will the proposed use promote a harmonious relationship of structures and open spaces to: the natural landscape: to existing buildings: other community assets in the area: D. What measures are being taken that show the use will not overload the City's resources, including: water supply and distribution system: sanitary sewage and storm water collection and treatment systems: fire protection, streets and schools: How will the proposed project mitigate any adverse impacts on the City's resources, as listed above? E. List the section(s) of the Zoning Ordinance that states what special regulations are required for the proposed project (Accessory apartment, home occupation, accessory structure, etc.) 3 **PLEASE SEE ATTACHED FOR ANSWERS TO ALL QUESTIONS** s. Special Permit Approval Criteria. If any permit criteria does not apply, explain why. A. How will the requested use protect adjoining premises against seriously detrimental uses? How will the project provide for: surface water drainage: sound and sight buffers: the preservation of views, light and air: B. How will the requested use promote the convenience and safety of pedestrian movement within the site and on adjacent streets? How will the project minimize traffic impacts on the streets and roads in the area? Where is the location of driveway openings in relation to traffic and adjacent streets? What features have been incorporated into the design to allow for: access by emergency vehicles: the safe and convenient arrangement of parking and loading spaces 2 CITY OF NORTHAMPTON ZONING BOARD OF APPEALS APPLICATION FOR: 1. Type of Project: j X SPECIAL PERMIT: X Home Occupation Accessory Apartment Historical Association/Society,et al Sign `Attaching Accessory Structure to Principal Building 2 Permit is requested under Zoning Ordinance:Section 10 . 10 Pg 1 Or 4 - 104 11. '11 11-19 11-21 3. Applicant's Name: Maren T Brown Address: 98 Lake St. Florence Telephone: 586-0901 4. Parcel Identification: Zoning Map# h Par*# 248 Zofaipg District: URB Street Address: 98 Lake Street:- Florlinge., P1A 01062-1321 5. Status of Applicant: X Owner; Contract Purchaser; Lessee Other (explain) 6. Property Owner: —same as above— Address: Telephone: 7. Describe Proposed Work/Project (Use additional sheets if necessary): Please see attached *****k***k k*k k k k k k***k*k**k***k****k**k*****k k**********k*******k**k********** Has the following information been included in the application? / ✓ Site/Plot Plan /V/A List of requested waivers ✓ fee($120.00) ✓ 2 sets of labels (supplied by the Assessor's Office) ✓ Signed dated and denied Zoning Permit Application ✓ Three(3)copies of the Certified Abutters List from Assessors' Office. 1 Zoning Board of Appeals Application for Maren Brown Requesting a Home Occupation Permit to establish an art business in her home located ' hw *°Frence, Massachusetts September 26, 1997 Date File 2 File No. REGISTRATION OF HOME OFFICE/OCCUPATION (§10.2 & 11.11) With the Building Inspector 1. Name of Applicant: MA1ZeW T. &F-0WP'-4 Address: q13 LA K6' ST. Ft,O F-E-NC,E —Telephone: 59t, -0901 2 . Owner of Property: - 6A-mg AS lac 3,OV f- - Address: Telephone: 3 . Status of Applicant: y%- Owner Contract Purchaser Lessee Other (explain: ) 4 . Parcel Identification: Map 7 A , Parcel Zoning District(s) (include overlays) U R3 Street Address 61,8 LA)Y-E ST , F L.0 R-E7NC;10 5. Narrative Description of Proposed Home Office: (Use additional sheet: if necessary) A pj?0)4 A ON `1tilE 5 60)V O VL60 - Ole Ay 1A0 uS6 W k tCA H&S Bit CoN VEXfib I» A-Y%J her STL+010 6. Is this a legal residential building? < NO 7 . Will there be an employee/owner who doesn't live in the home YES Q 8 . Will you ever see clients or customers at your site? YE NO How often O - 3 G w e-NTS /MONTH For what purposes -tb Se-E My Acip-TWog K- 9 . Will there be any signs for the Home Office? YES Q lo. 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? � 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) ? ES NO If NO explain: 13 . Attach Plans (if applicable) 14 . Certification: I hereby certify that the information contained hereii 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-crimin fines an( criminal and civil actions. Date: Ot / C17 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 RENEWEI Denied as presented---Reason: Signature of Building Inspector Date NOTE: Issuance of a permit does not relleve an applicant's burden to comply with all zoning requirements and obtain all required permit from the Board of Health,Conservatton Commission,Department of Public Works and other applicable permit granting authorities. 10. Do any signs exist on the property? YES NO X 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 col— to be filled in O('C, by the Building Department Required Existing Proposed By Zoning Lot size Frontage Setbacks - side L: R: L: R: - rear Building height Bldg Square footage %Open Space: (Lot area minus bldg ' &paved parking) of Parking spaces f %f Loading Docks Fill: 4 vol-ume--& location) 13 . Certification: I hereby certify that the information co ined herein 1 is true and accurate to the best of my knowledge. DATE: APPLICANT's SIGNATURE NOTE: Issuanoe of a zoning permit does not relieve an pplioant's b den to oomp, witf)1,,�11- z9ning requirements and obtain all required permits from the Board of Health, Coneervtstion Commission, Department of Publio Works and other applionble permit granting authorities. FILE # IV ` 2 71991 Fi 1 e No. J� ZONING PERMIT APPLICATION (§10 . 2) PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: M A IZ E N T. B kO W r4 Address: q8 I.A1=E !,T. PL-0 rz kF- I(_E Telephone: 596-0101 2. Owner of Property: — SAME AS h5a V IF Address: Telephone: 3. Status of Applicant: _Owner Contract Purchaser Lessee Other(explain): 4. Job Location: Parcel Id: Zoning Map# Parcel#d�T District(s): (TO E ILLED IN BY THE BUILDING DEPARTME 5. Existing Use of Structure/Property 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): A R1' STtA D 10 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 KNOINf .X YES IF YES,date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO DON'T KNOW X 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) FIDE # 9 6 14 9 y' AUG 7 IN APP ICANT/CONTACT PERSON: ADD,RESS/PHONE: PROPERTY LOCATION: C��!� MAP PARCEL: ZONE THIS SECTION FOR_OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLQSED,REQUIRED DATE Rifflr1ing Permit Filled nilt- Type of Constniction- Tnelyided- a THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS AP ICATION' Approved as presentedfbased on information presented Denied as presented: 000",_ p N Special Permit and/or Site Plan Required under: § d�-1°05 /4 PLA.NNINGBOARD ZONINGBOXRD n . how Received & Recorded at Regi'stry�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 mission Signature of Building Date NOTE:lasuanoe of a zoning permit does not relieve nn applicant's burden to comply with all zoning requirements and obtain ell required permits from the Board of Health, Conservation Commisaion, Department of Public Works and other applicable permit granting authoritles.