17C-183 (5) s '
10 Do any signs ebst on the property? YES NO
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO__�D�
IF YES,describe size,type and location:
II . ALL INFORMATION MAST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
Thi: cola== to be filled is
by tbn Building Depertm.nt
Required
Existing Proposed By Zoning
I
Lot size /,5- 7� /`j �� �����
Frontage �O
Fr e g
Setbacks -- fm '20
- side L: �) R: L: R:
- rear
�O
Building height
Bld g Square footage
2l0°�0 �l J 9(07o
%Open Space: _
Lot area minus bldg
&p=eed parkingN
# of Parking Spaces
f of Loading Docks
Fill:
vol-ame--& location) QA
Np�
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my �kdge.
DATE: Zit c APPLICANT'S SIGNATU
NOTE. lanumnoe of at zoning permit does not relieve an applionnt's urd to comply wltla�$1
zoning requirements and obtain all required permits from the B rd o Health, Conser"Vatic
Commission, Department of Publio Works and other applicable permit granting authorities.
FILE #
T
r
i II U
FEB 16
Fi 1 e No.
'FPTOF9F - "INSPECTIGP,,` � �� /as
ING PERMIT APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: �e.��,� ��a� Cq
Address: �J� CZIUJG�I/�� t1'1�� • Tln/IfIX Telephone:
2. Owner of Property: LAwl L41`� AtA�n
Address: CVI�C3 "& mil. C�OSCY1(� �r� Telephone:
3. Status of Applicant: Owner _Contract Purchaser Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map# Zr7e-- Parcel# 3 District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property
6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
yze
Rrjp,r, 1�0
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
�Answers to the following 2 questions may be obtained by checking with the Building pt or Planning Department Files.
8. Has a Special PermitA/ariance/Finding ever been issued for/on the site? jvm-� �'Vtk v.)
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_�O 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-2000-0125
APPLICANT/CONTACT PERSON SYLVAN PETER
ADDRESS/PHONE 31 TEAWADDLE HILL RD (413) 549-5903 O
PROPERTY LOCATION 57 CHESTNUT ST
MAP 17C PARCEL 183 ZONE URB
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLS OUT
Fee Paid J
Buildin,,Permit Filled out
Fee Paid
Typeof Construction: CHANGE FROM 3 TO 4 FAMILY RESIDENCE
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 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: S _ w/ZONING BOARD OF APPEALS
_Received& Recorded at Registry of Deeds Proof Enclosed
4ZVariance Required under: S :S� Z _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 Conin i
_ Z '6C)Zj
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.