17C-248 (2) r
�O G�
r'
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
IF YES,describe size,type and location: hNtc -uc it 5 t.4 I.5
v
11. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This cola to ba filled in
by the Bai.lding Daepartmnnt
Required i
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
#' of Loading Docks
Fill:
vol-ume--& location)
13 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
DATE: D Z APPLICANT's SIGNATURE
NOTE: Issuanoe of a zoning permit does not relieve an applicants burderYtcp oompty WIt4 .all
zoning requirements and obtain all required permits from the Board of Health. Conservation
Commisslon, Department of Publio Works and other appliomble permit granting authorities.
FILE #
IJ
Fi 1 e No.-RPO-13k
ZONING PE=T APPLICATION (§10 . 2)
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: Q J)/r Z.
Address: Ne,/ �1 `5 --�eY�rrc jeIephone:
Owner of Property:
Address: � h, in L. i t� 5 I n��U,c_ Telephone:X
3. Status of Applicant: --Owner Contract Purchaser Lessee
Other(explain):
4. Job Location:
Parcel Id: Zoning Map# Parcel# District(s):
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Existing Use of Structure/Property oZ
,f! Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary):
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 ✓ 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 Doc went#
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)
i
� I^
?
Date Filed l>.,R �uG3 File No. ,3- )Vf
REGISTRATI01Z-OF-IOME O�FICE/OCCUPATION (§10 . 2 & 11. 11)
r "` T�Ti�th the 'Building Inspector
1. Name of -Applicant:
Address: lS�i'f�I �v�n Lit f z -e ir, Telephone: t,// 1-5 -D �
2 . 16�ner of Propel_ 1��J^�I 1� � � i c5Ci I j'O WA�C?4�7 Sit
Address: �`� r /y1��irS St Fl �'►'���c- 1'el_ephone:X
3 . Status of Applicant: ✓Otincr Contract Purchaser Lessee
Other (explain: _ )
4 . Parcel Identification: Map x J�, Parcel -: J�8,
Zoning District(s) (incl de over a s)
Street Address � ,de
fj �
S . Narrative Description of Pi,oposed Home Office: (U e .additional sheets
if necessary)
G . Is this a legal residential building? ES NO
7 . Will there be an employee/owner who doesn't live in the home Y NO
8 . Will you ever see clients or customers at your site? YES NO
How often A's 114 F1 �1
For what purposes I3,1 11; s
9 . Will there be any signs for the Home Office? YES NO
lo . Will there he any goods sold from the premises or any sale of O
goods stored on premises , either retail or wholesale, or any—
display of goods on premises? �YESI 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 fro
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 and
criminal and civil actions .
Date: Applicant' s Signature:
THIS SECTION FOR OFFICIAL IISE ONLY:
Approved as presented/based on information presented
PROVAL EXPIRES N DECEMBER 31 OF THIS YEAR AND MUST THEN BE RENEWED
Denied presen d---Reason:
Signature of Building Inspector Date
NOTE: lasuanco of a pocmlt doe:not rallovo an appllcant'a burdon to comply with all zoning roqulromonta and obtain all roqulrod pormlts
from Vio Board of Health,Conaotvntlon Commisslon, Dopartmont of Public Works and othor applicable pormlt granting authorltlos.
File#MP-2003-0138
APPLICANT/CONTACT PERSON DIAZ ALICIA
ADDRESS/PHONE 65 NORTH MAIN ST (413) 582-0391 ()
PROPE
MAP
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid
Building Permit Filled out
Fee Paid a —
Typeof Construction:_HOME OFF/OCC REG-PAINTING BUSINESS
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 BASED ON
INFORMATION PRE TED:
Approved .,
PLANNING BOARD PERMIT REQUIRED UNDER: §
Intermediate Project: Site Plan AND/OR Special Permit with Site Plan
Major Project: Site Plan AND/OR Special Permit with Site Plan ,-��`
ZONING BOARD PERMIT REQUIRED UNDER: §A AD. /Z
Finding Variance*
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 Commission Permit from CB Architecture Committee
Permit from Elm Street C mmission
7 le2,
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.
* Variances are granted only to those applicants who meet the strict standards of MGL 40A. Contact the Office of
Planning&Development for more information.