24A-005 (5) oy
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Date Filed '1j/j.., File No. .0 -f A - v 5
REGISTRATION OF HOME OFFICE/OCCUPATION (510. 2 & 11. 11) Lt P
With the Building Inspector
1. Name of Applicant:- / 2 e„i Z 4 S j /11�,. ! 7 .v
Address : _,2ii N Lc'i en 5 Telephone: ,.c y 7,Y'T s
2 . Owner of Property: f c,,,.1 S j 11 6r i,,,,
Address: 14, ti, ? , ,,., :";- Telephone: 3-'z'- >J'i._S—
3 . Status of Applicant: 'ner Contract Purchaser Lessee
Other (explain: )
4 . Parcel Identification: Map # j1/04- , Parcel # !j ,
Zoning District (s) (inc ude ov 1 ys) Ct,Q�
Street Address Qil IL • ,,>_,
5. Narrative Description of Proposed Home Office: (Use additional sheets
if necessary) rl n���•7,- 4„,4„, / e F ol,, ,, C ;.�.;11 ),,_- r, ,,�- ,i _. s
()/- id)c� N. (-
1 (-,et- S - . .7`., 1)/ .<,,, , ✓ ,l c.,n.,,=,-
6. Is this a legal residential building? YE NO
7 . Will there be an employee who does not live in the home? C NO
8 . Will you ever see clients or customers at your site? NO
How often „c-py dc:c-z^,;r.�,i,,
For what purposes /,,,,k , `,/>-, c 7 c..
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 40
11. Will there be any outdoor storage of materials? y-7-,tie.-/ YES 410
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
If NO explain: -sc—c.- c/-,if',,,.,:r c%%� ,-,;). ,pv-= /i � <
t� g�N�- a� � s��
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: S .,�j�j� - Applicant's Signature: L' ,,.,, i�� C
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
A PROVAL EXPIRES ON DECEMBER 31 OF THIS YEAR AND MUST THEN BE RENEWED
ie as esented---Reason:
Signat " o Building specto Date
NOTE: Issuance of a permit oes not relieve an applicant's burden to comply with all zoning requirements and obtain all required permits
from the Board of Health, Conservation Commission, Department of Public Works and other applicable permit granting authorities.
IL / I
tom•,(.0f. ''l .
.1 r.,- y
- File No. ',�F /� - o
Date Filed 00;1- 0 0 0 2
ZONING PERMIT APPLICATION (S10 . 2 ) LLI? 13
1 . Name of Applicant: �c.-n ,.. 5---, „).—�.
Address : J ,, K,,�,,,i ;, Telephone: �s'Y 7fk—
2 . Owner of Pr.operty i7 ,4)-. Si".%),i;
Address : 9 ,, ,,;,-,„? >;-- Telephone : 57'q 7( ? -.-'
3 . Status of Applicant : Diner Contract Purchaser
Lessee Other (explain: )
•
4 . Parcel Identification: Zoning Map Shee # /4 Parcel# ,
Zoning District (s) (include, o erla s) GCK�
Street Address 2(( 1l (ex -. •
Required
5 . Existing Proposed by Zoning
Use of Structure/Property .
(if project is only interior work, skip to #6)
Building height
*Bldg. Coverage (Footprint)
Setbacks - front
- side L___ J L R
,— - rear •
Lot size
Frontage •
Floor Area Ratio
%Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location) 1
6 . Narrative Description of Proposed Work/Project: (Use additional sheets
if necessary) Ac•'eO,r/J,,..,Cc, fiy /o,.c 6.i ,,, , t9,`,'✓pima• .,,
•
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: i1by/lam Applicant ' s Signature. �s 1' - .' .'�_"�.__.
.� F -F' n n r.� r�••
THIS SECTION FOR OFFICIAL USE ONLY: 4 'i
t AUG 2. 6 ' ' )
pproved as presented/based on information presented '�'�`
Denied as presented .
eas n for en 'al : //,, I ) 5 pp, ,r,s
ignati • f B nspector Date
NOTE: issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning roquirernents and obtain all required permits
from tho hoard of Hoafth, Conservation Commission, Department of Public Works and other applicable permit granting authorities.
7/92 FXAS
PERMIT APPLICATION CHECK LIST
PAGE = PLOT C1 5 ZONE CLF 1Q 8 i m �r YES NO DATE
all N.
1 . ZONING FORM APPLICATION 1 16 -9 a
2 . PERMIT APPLICATION
3 . OWNER OCCUPANT STATEMENT / LIC . # IF NOT
A. 3 SETS OF PLANS /PLOT PLAN
5 . NEW CONSTRUCTION
}
6 . CURB CUT
7 . WATER AVAILABILITY FORMS
8 , REMODELING INTERIOR
9 , ADDITION -
10 . ACCESSORY STRUCTURE
11 . SIGN / AWNING
12 . PERMIT FEE - CHECK ONLY - MONEY ORDER
13 , SPECIAL PERMIT REQUIRED WITH DEED IF APPLICABLE
14 . UNDER SECTION 127 - CMR 780
15 , FORM A
16 . FILL
COMMENTS :
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