HomeMy WebLinkAbout075-04
TOWN OF NANTUCKET
BOARD OF APPEALS
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To: Parties in Interest and. others concerned with the
Decision of the BOARD OF APPEALS in the Application of the
following:
Application No.:
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Enclosed is the Decision of the BOARD OF APPEALS WhlCh has
this day been filed in the office of the Nantucket Town
Clerk.
An Appeal from this Decision may be taken pursu~Rt to
Section 17 of Chapter 40A, Massachusetts General LawS.
Any action appealing the Decision must be brought by
filing an complaint in court within TWENTY (20) days after
this day's date. Notice of the action with a copy of the
complaint and certified copy of the Decision must be given
to the Town Clerk so as to be received within such TWENTY
(20) days.
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cc: Town Clerk
planning Board
Building Commissloner
PLEASE NOTE: MOST SPECIAL PERMITS AND VARIANCES HAVE A TIME
LIMIT AND WILL EXPIRE IF NOT ACTED UPON ACCORDING'TO NANTUCKET
ZONING BY-LAW ~139-30I (SPECIAL PERMITS); ~139-32I (VARIANCES)
ANY QUESTIONS, PLEASE CALL THE NANTUCKET ZONING BOARD OF APPEALS.
ZONING BOARD OF APPEALS
1 EAST CHESTNUT STREET
NANTUCKET, MASSACHUSETTS, 02554
Map 73.3.1
Parcel 118
Sconset -Old-Historic
8 Grand Avenue, Siasconset
Lot 5, Plan File 9A
181/299
At a Public Hearing of the NANTUCKET ZONING BOARD OF APPEALS held at 1 :00
p.m. on Friday, November 19,2004, in the Conference Room, Town Building Annex, 37
Washington Street, Nantucket, Massachusetts, on the Application of BETTINA BROER and
PETER W. BROER of Box 168, Siasconset, Massachusetts, 02564, Board of Appeals File No.
075-04, the BOARD made the following DECISION:
1. Applicant is seeking relief by SPECIAL PERMIT under Nantucket Zoning By-
law Section 139-33A (alteration/expansion of a pre-existing non-conforming structure/use).
Applicants are seeking validation of an addition that was constructed pursuant to a duly issued
Building Permit. The covered porch was removed, reconstructed, and converted into interior
living space and sited no closer to the northerly side yard lot line than the existing structure.
However, special permit reliefwas required to replace the structure in the setback area and no
such relief was sought, as the intent was to place the new addition in compliance with the five-
foot side yard set back requirement. The addition was constructed further from the lot line than
the covered porch, but was sited as close as about 4.1 feet from that lot line in a district that
requires a minimum side yard setback of five feet (the house is sited at zero feet from the same
lot line). There is also an attached bike rack with small "pent" roof over the top of it to protect
the bikes from the elements in the same area, which is sited no closer to the lot line than the
existing structure.
The Premises is located at 8 GRAND AVENUE, SIASCONSET, Assessor's Map
73.3.1, Parcel 118, Plan File 9A, Lot 56. The property is zoned Sconset-Old-Historic.
2. The Decision is based upon the Application and materials submitted with it, and
the testimony and evidence presented at the Hearing. The Planning Board made no
recommendation, as the matter presented no issues of planning concern. The direct abutter to the
north, represented by counsel at the public hearing, requested that the Applicants remove a six-
inch encroachment onto his property from the abutter's property and the Applicants agreed to do
so as a condition of relief being granted.
3. Applicants, through personal testimony and through counsel, represented that they
had submitted a building permit application in July of2003 to the Nantucket Building
Department to remove an existing covered porch on the easterly side of the their single-family
dwelling and to construct an enclosed porch to create additional interior living space. Applicants
stated that the dwelling on the property was constructed in the 1890' s and was a validly pre-
existing, non-conforming structure shown on a 1957 aerial photograph of the property in the
town records substantially in its present location. The building permit application stated that the
new addition to the cottage would conform to the minimum five-foot northerly side yard setback
requirement. However, Applicants represented that during the course of construction, an
inadvertent error occurred and the fmished wall of the addition was sited approximately 4.1 feet
from the northerly side yard lot line, with the overhang being sited as close as about 3.5 feet and
a roofed over storage area being sited as close as about 1.3 feet, none of which is closer to the
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northerly side yard lot line than the existing structure. There was no testimony available from the
builder as to how the error was made given that said builder was recently deceased. Applicants
represented that a small, pre-existing, non-conforming shed attached to the cottage encroached
approximately six (6"t) inches onto the northerly abutting property owned by Joseph and Linda
DiMartino located at One Ocean Avenue, Siasconset, Massachusetts. Applicants agreed to cure
this encroachment on or before March 1, 2005.
4. Therefore, based upon the foregoing, the Board finds that the validation of the
siting of the addition, overhang and storage area by special permit would not be substantially
more detrimental to the neighborhood than the existing nonconforming structure. There would be
a benefit to the neighborhood in that the encroachment onto the abutters' property would be
cured, though the structure would continue to be sited as close as zero feet from said lot line.
5. Accordingly, by UNANIMOUS vote, the Board GRANTS the requested relief by
SPECIAL PERMIT under Zoning By-law Section 139-33A to validate the siting of the addition
to the structure, including overhangs and storage area as constructed, subject to the following
conditions:
a) Applicants shall cure and remove the portion of the existing shed
encroaching onto the northerly abutting property owned by Joseph and
Linda DiMartino and located at One Ocean Avenue, Siasconset,
Massachusetts, 02564 on or before March 1, 2005; and
b) The siting of the addition, overhangs and storage area shall be
substantially as shown upon the "As-Built Plot Plan", done by Richard K
Earle, licensed surveyor, dated September 16,2004, a reduced copy of
which is attached hereto and marked as Exhibit A.
Dated: December L, 2004
Nantucket, MA
Edward Murphy
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CURRENT ZONING: l20H -t}&I.""~~,,f'A{>I'ifZ8I')fD,-.if,. ~-- h'V---r-
MINIMUM LOT SIZE: Sa:v:? F. adcpf,on ,/\s'fb/,v. c-,I,..."! J.~w
MINIMUM .FRONTAGE: ~' {t7~~).:l- nof-<<. -:-> ~ (<'I.., ..f AS-BUILT PLOT PLAN
FRONTYARD SETBACK:. NoNe" Ide ~A-, no buiid,"fJ f"Zr""if61-./ tI,,/Jle-i,., '''''2... N .
SIDE AND REAR SETBACK: &;;' ~ f./~ .:Jid" _I d.uc.ll.Irf!:. iJ-r, nof NANTUCKET, MASSACHUSETTS
ALLOWABLE G.C.R.:. ~1- -Q:>n/~ .,t,; CUY',...ql? f _~..c>t. ~ SCALE: f"= /0' DA TE: .~ /t4>{ 0"1-
EXISTING G.C.R.:. ,8.1 '/. *3) 0#"";6 T. "rH-.cI..rc ~ C4",pj"./ f..
FOR PROPERTY UNE DETERMINATION T1-IIS PLOT PLAN 1-o,.".=r<l /I~ f(,r /cc.... (<'I.,., """.I cI~"'..n,>,) DEED REFERENCE;,~ le.I Pc.- ~'J':l
REUES ON CURRENT DEEDS AND PLANS OF RECORD, 01" "nown on 1"10/., file !:lA, PLAN REFERENCE: F'I..Alo.\ F'1\..e ~ A
VERIAED BY FiaD MEASUREtolENTS AS SHOWN HEREON. ASSESSOR'S REFERENCE:
T1-IIS PLAN IS NOT REP.RESENTED TO BE A Tln.E MAP: 7.3..3.1 P ARCEL: ~1e:>
EXAMINATION OR A RETRACEtolENT SURVEY. - PREPARED FOR: f'e;rSR. ~~a2. 't
I HEREBY CERTIFY TO THE BEST OF MY KNOWLEDGE e>en'1>l4 ~"t
THAT THE PREtollSES SHOWN ON T1-IIS PLAN ARE .. .' . -,
LOCATED WITHIN THE C ZONE AS DEUNEATED
ON THE "FIRM" MAP OF COMMUNITY NO. 250230;
MASS. EFfECTIVE: 6-3-86 BY THE FEDERAL
EtolERGENCY MANAGEMENT AGENCY.
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NANTUCKET SURVEYORS INC.
5 WINpY.WAY
NANTUCKET, MA. 02554
N,...'7"I"I7
TOWN OF NANTUCKET
ZONING BOARD OF APPEALS
1 EAST CHESTNUT STREET
NANTUCKET, MASSACHUSETTS 02554
PHONE 508-228-7215
FAX 508-228-7205
NOTICE
A Public Hearing of the NANTUCKET ZONING BOARD OF APPEALS will
be held at 1:00 P.M., FRIDAY, NOVEMBER 19, 2004, IN THE CONFERENCE
ROOM, TOWN ANNEX BUILDING, 37 Washington Street, Nantucket,
Massachusetts, on the Application ofthe following:
BETTINA AND PETER W. BROER
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BOARD OF APPEALS FILE NO. 075-04
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Applicant is seeking relief by SPECIAL PERMIT under Nantucket Zoning~-
law Section 139-33A (alteration/expansion of a pre-existing nonconforming ~.~
structure/use). Applicants are seeking validation of an addition that was constructedD
pursuant to a duly issued Building Permit. The covered porch was removed,
reconstructed and converted into interior living space and sited no closer to the northerly
side yard lot line than the existing structure. However, special permit relief was required
to replace the structure in the setback area and no such relief was sought, as the intent
was to place the new addition outside of the required five-foot setback area The addition
was constructed further from the lot line than the covered porch but was sited as close as
about 4.1 feet from that lot line in a district that requires a minimum side yard setback of
five feet (the house is sited as close as zero feet from the same lot line). There is also an
attached bike rack with small "pent" roof over the top of it to protect them in the same
area, which is sited no closer to that lot line than the existing structure. The Locus is
conforming in all other respects to the zoning requirements.
The Premises is located at 8 GRAND AVENUE, SIASCONSET, Assessor's
Map 73.3.1, Parcel 118, Plan File 9A, Lot 5. The property is zoned Sconset-Old-Historic.
N~~~~V
THIS NOTICE IS AVAILABLE IN LARGE PRINT OR OTHER
ALTERNATIVE FORMATS. PLEASE CALL 508-228-7215 FOR
FURTHER INFORMATION.
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NANTUCKET ZONING BOARD OF APPEALS
.. 1 EAST CHESTNUT STREET
NANTUCKET, MA 02554
CASE NO.O 7~ .... O~.
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. APPLICATl9N FOR RELIEF
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Owner's name(s):~ro ~ ~ ~~
Mailingaddress:~ {~~ 91~'5~' ffiH oztSC..Lf
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Applicant's name(s): ~(6) ~~
Malling address:. ~ &~ <Sl\:oJe.
. Locus 'address: e G1lQ~ @0EV\Of) ~ Assessor's'MapfP~rcel: 1-3..3~f-:," U8
Land Court PlanIPlan Book & PagelPlan File No.:_ften -t:;~\ <r. . qjj . . Lot No.: LOt 5
Date lot acquired: Jf In 81 Deed Ref.lCert. ofTitle:~Zoning i)istrict:~
Yses on Lot - Commercial: None ./. Yes (describe)
. ReSidential: Number of dwellings-L- Duplex---: Apartments
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. BuDding Date(s): All pre-date 7 n2?.J/?iL or
BuDding Permit Nos: tt8:> -O~
Previous Zoning Board Application NOs.:-,,\'OO'C:.
. State below or on a separate addendum specific reli~f sought (Special Permit, Variance, Appeal), Section of
the Zoning By.;.law, and supporting details, grounds for grant of relief, listing any existing nonconformities:
~!'\v\ ~'fI\\-r '* ~,~O() ('i\'eltncOJV) ') 'cn;\oq 4-~'}j{dJVJ
M-ee1:i U I\'C - re.-t'voclc \':, 5) ~ I
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Rental Rooms
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I certify that the information contained herein is substantially complete and true to the best of my
knowledge, under the pains and penalties of perjury.
SIGNATURE: tf<S). Applicant !/' Attorney'Agent
(If not owner or owner's attorney t please enclose pro f of agency to bring this matter before the Board)
. .~ 00 WAOm~UB .
Application reeeivM on: 101157.54 By: Complete: . NeM coples?:~\
Filed with Town Clerk:.1JJDOi Planni Board: . iug Dept.: I_/~~
Fee deposited with Town Treasurer:Jl,J:J~ By: Lt~aiver requested1:_Granted:_'-'_
Hearing notice postM with Town Clerk:J1!.~ tti. MaUed:J1' ?" cl I&M:J..k:LQ;{ & J.1Jlfl4t.
Hearing(s) held on:_'_'--: Opened on:--1_'_ Continued to:_'_'_ Withdrawn?:_'_'_
DECISION DUE BY:_'_'_ Made:_'_'_ Filed wrrown Clerk:_'_I_ Mailed:_'_'_
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I.tOfHCAGE INSPECTION PLAN \
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BUILDING/STRUCTURE INVENTORY FORM
NANTUCKET ISLAND ARCHITECTURAL
AND CULTURAL RESOURCES SURVEY
NANTUCKET HISTOnlC OISl RICT COMMISSI)N
NANTUCI<ET, MASSACllUSETfS
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SURVEYI
FILM ROLL II: SC 5 - 14
M^~PARCELII~331-11B
" ",' ",. R e cor c1 e d by: A H
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;)i.i:;~;J.I DENT I F I rAT I ON
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Date: 09/14/B9
Organization: AGS
Street Name ~'<: No.: 8G RAN D AVENUE
Bui Iding Name: YAWL
Ownership: Private
Present Owner: BROER, BETTINA ~ PETER
Ownership History:
Unknown
Use: Original: Guesthouse - Present: Dwelling
Seasonal/Year-Round: Seasonal
Accessibility to Public: Visible from Public Road? Yes
Interior: N/A
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Survey/Film Roll It: SC5-14
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IENERAL SETTING AND ORIENTATION OF BUILDING
10. Lot Size:N/A
11. Approximate Frontage (ft.); N/A
12. Setback from Street (ft.); At Sidewalk
13. Orientation to Street Address: Gabled
14. Surroundings; Densely Bui It,Residential,
Old Historic District
15. Related Outbuildings and Property: N/A
16. Other Notable Features;
N/A
DESCRIPTION
17. Foundation: Unknown
18. Structural System: Woodframe
19. Exterior Wall Material, Front Facade: Shingles-Weathered
20. Exterior Wall Material, Side Elevations: Shingles-Weathered
21. Exterior Wall Material, Rear Elevation: Shingles-Weathered
22. Number of Stories: 1
23. Roof Shape: Gable
24. Roofing Material: Composition Shingle
25. Roof Features: N/A
26. Dormer Roof(s): N/A
27. Chimney Material: Brick-unpainted
28. Chimney Position: End Wall
29. Number of Chimneys: 1
30. Chimney Features: N/A
31. Front/Primary Door Location: Off Center
32. Front/Primary Door Frame Features: Flush Frame
33. Number of Bays: N/A
34. Window Frame Type: Flush
35. Window Sash Type(s) - Front Facade; 4/4,8/8,
40LF,8LF
36. Porch: N/A
37. Signage: N/A
38. Detai Is; Corner boards-plain
39. Condition: Good
40. Integrity: N/A
41. A I t era t ion 5 :
N/A
,/
iE 3
Survey/Fi 1m Roll It: SC5-14
SIGNIFICANCE
42. Role the Building Plays: National Register: Non-contributing
43. Date of Initial Construction: SInce 1949
Source: Sanborn Maps
Architect: Unknown Builder: Unknown
44. Bui lding Type: Additive,Side Gabled
45. Architectural style: NIA
46. Historical and Architectural Importance:
Unknown
47. Sources: Sanborn Maps 1923, 1923/49
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Nantucket Reg of Deeds
"...-.(,lfl_"". ~';"'e"'I'" .... _He..,. .0... t"..onnOVA..l 001
I, DAVID F.. rwING,
.... 181 iA.': 2U!J
of 1041 Hino lIill l'Ioo.d, Folrf1cld, C1' 0600
l(fflli1'illr~~.l~:Mni'
a~q~~~for COll$ldeutio'l p,id. and in lull c.n'lsid('(~,i(l~ of S 5 8,000.00
}l'Jf\tltO l'~t~ OFlOER cnd Bl'.TTINA nnol".j\ 011 t'lnAn=. 1n COI!\1l\Ott
.
of 12. WeRt 7Jrd Stre<!t, New York, NY l(02)
with ql.lttlulm 1lI11flll1nt4
Ih~IQ"d;n the T<lWtI and County of Nantuek.:!t, COlM\on...e<llth of MAI.DC~~.ott.,
situate at 51.scon.at, and boundeo ~nc dClcr10Qd a. tellowsl
XIaI(....~~H~~
NORTI/&R%,V
by lan~ now or forrneTly of M1ch~el ~. F1nnall
and P.tri~tQ F. ~u1ha, bcinq Lot A On L.nd
Court plan NO. 935~-^, lD6.62 fQotl
tMTF.J{L'i
by lAnd now or fQr~erly or .~ld Finnell and
~~lha. bc1n9 Let 4 On L~nd C~~rt PlAn No.
2~674-A. 25.67 feet, end by LOt 3 on tho
Plan heroin. )0,00 featl
by LOt. 4 and 6 o~ the Pl~n hereinafter re-
fer.ed to, ~4.6' feet, e~d b~ Lot 7 on said
plan. 48.19 f~etl and,
by "rnnd ~vcnue, 50.00 teat.
SQUTHEttL'Y
Wr:~'rl::Rt.Y
Said pr~i~e' .re lubject to e PQrpetu~l @~semqnt and rlght of way
appurtenant to Lot ) On toe Pl~n he~cina(ter referred to for foot travel
to and fro~ Cctt~9o Avenue and for the in~talldtion a~d rn~intenanco of
~nderg~ound conduits, pip~., and lines for electric. water. sewer, tele-
phone. cable television, and other information tran~~itt.l seCv1cQ fco~
Cott~qe AVenue to the ..id Lot 3 over, along, and under that partion of
the ten (lO"-foot wide (ex~andinq to twenty (20') foot vl~th at Cotteqe
^ven~e) ~trin of lan4. shown as an F,alement on sala TIen, as 1100 within
the bound. of the pre~i'e' here1n.
S.i~ p~.~1.e. are .hown .5 Lot 5 on a Plan of Land in ~.ntuc~et.
Ma..., dated ~p~il 28, 1990, d~awn by schofield Brothers, Inc., prep.re4
for Oavid E. Ewinq, and re;ord.e at the N.ntucket ~e9i.try oe Deeds 1n
Plan P'Ue 9^.
For my title see Deed of ~obert N. Wilay recorded at thQ N8ntuc~et
R.~1.try of Deeds in aook 175. i.ie 54.
mltn'lIllroy.... b4M
_2.~W~;~n~.;': "
aM acal
thit.....
t5iJf ~lImulllWtlllt1r at tlhllllllf!JII.n.
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Nantucket,
I,pril ? '
~~.
.'.
DAVID &. ~IN(; . ,_~ ~ ~ ,. r .,. ~~ ~ ,'\
.~ '_ ',~, 't .--:,' " I ! ("l.
hh lc~~ lid 8M d<<d, !Klore 1M .~:::~ '). ,.,"::'-:,'" ,-
.~,/~~ ."L~..,~~~:.:.'.i>:':" .
Nooa" ....'11. -.I)t~)I~JQ:dl
.W;!I~ !II.,.. ,.: 19
'Then pcraon,dly ap~areG the abo.,e lumed
an<! ,&roow 1cJllt'd die fOfCPs insttv",ent to bo
NANTUCKET COUN'N
R~eived ano En tered
<no' " ~.'- )oI,~.....,l",
~ ~~ r-t.I1wtr a..hl.(
Attest APR 81961 JAy ("~JI"" '_1'IOl A;"ll 14 ;1..
, . (-Jnd!.k11M1 -]<JiJ1t 'I'Of1tn'l -T~naatJlnc.cm_)
~ If)" {t M (\It!1mJ''l Irc. , AS AM1!i"<1)!;O" .'. _
f."'1 n..,IS-"'N 'Of ,~'I\~j'1:.;;..I. Ir hI'. ...,J....,j .jWm I' , 't' l;<'21,v-AONWf^L1H .'"
,r1<! J. H'Clld aI ole '''''''IIM oIlhr '~l" ~4n4e,.,,- dlC"tCVll" *-141. .. t r.; :) ~ a J.' ( ~
tM . tllllli!tt ff1tMtth,'T t~'1t. TM '~U Mfl~lJt'M.ft &hill ..,.D "11 Iou" t .. . , C i-' - . - r'lI
tr'i~lkJb.roJ4J(.j Unll1lf"1 .., ,.. ,raNN' ttf feMtt,., ...,... An ........ : 1 :.. ~ s
,,1'.... .. """or" .,&11 1ioI. _... ..... ... I'''' .. ..litlitp '" ...,..... ~ - ..
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Town of Nantucket
OCT 1 4 2004
ZONING BOARD OF APPEALS
LIST OF PARTIES IN INTEREST IN THE MATTER OF THE PETITION OF
PROPERTY.OWJ-jEK"'.~r""~""?::~
MAILfNG ADDRESS""""""",,,,,,,..,,,, i7~""'''''''''' '''''' '7/""".' ,.
PROPERTY LOCATION.....,....?...~~cf:.....~...
. .: 733 / - /1. r7
ASSESSORS MAP/P ARCEL:....................... ..I.. . J).............................
A P P LI CANT.. . . . . .. . . .. . .. . . . .. . .. .. .. .. . . .. .. . .. . . . .. . . . . .. .. .. . .. . . . ... . . .. . .. . .. .. . .. . .. . . ..
SEE ATTACHED PAGES
I certify that the foregoing is a list of persons who are owners of abutting property, owners of
land directl" opposite on any public or private street or way; and abutter.s of the abutters and all
other land owners within 300 feet of the property line of owner's property, all as they appear ~:>n
the most recent applicable tax list (M.G.L. c. 40A, Section 11 Zoning Code Chapter 139.
Section 139-290 (2) .-
tlei;'./0J?o..o.i/
~a~
DATE'
ASSESSOR'S OFFICE
Town of Nantucket
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RECE\VED
M~'( 2 8 lGG3
NANTUCKET
G DEPT.
trY~-03
S-;;r
BUILDING PERMIT NUMBER
APPLICATION FOR .
BUILDING PERMIT
IMPORTANT _ Applicant to complete all items in S~ctions: 1, 2, 3, 4, and 5
OWNERS NAME (print): B~ ~lr&.
Olrt. -Last FI,k Middle Initial
B ~ ~~'J\cr -1 ~'5e-\-
No. Street
Assessor'S Map No. 33.. 3.. l
Assessor's Parcel No,
\{B
1.
LOCATION
OF
BUILDING
2. TYPE AND COST OF BUILDING - All applicants complete Parts A-E
A, TYPE OF IMPROVEMENT
o New Building
~ Addition
o Alteration
o Repair, replacement
o Demolition
o Moving
B, OWNERSHIP
T2C Private
o Public
D, DIMENSIONS
Dimensions of Structure
First Floor Area: 1.2./)( 22 '
Second Floor Area:
~~~'
C.COST
TOTAL COST OF IMPROVEMENT
~~~ ('f)D
J
Third Floor Area:
Total Floor Area: ~
Full Cellar Area:
E. PROPOSED USE
Residential
Detail scope of work by floor & provide the
square footage,
Tg One Family
o Studio
o Two or more family - Enter
number of units
o Hotel, Motel, Dormitory
enter number of units
o Second Dwelling
o Garage
o Pool
o Other - Specify
3. SELECTED CHARACTERISTICS OF BUILDING
For new buildings and additions, complete Parts D-N
for Demolition, com lete-OrilVl'art 1., for all others ski to 4.
F PRINCIPLE TYPE OF FRAME
~ Wood frame
o Other - Specify
H. TYPE OF SEWAGE DISPOSAL
~ Public
o Private (septic tank, etc.)
K. ACCESSORY HEAT SOURCE
No. of fireplaces 0
No. of Wood Stoves 0
Other:
o Gas
o Electricity
I. TYPE OF WATER SUPPLY
'!f Public
o Private (well)
G. PRINCIPLE TYPE OF HEATING
o Oil 0 Heat Pump
o Other - Specify
\-tt9J5'l\'S ~~~~~ J
J. SMOKE DETECTORS
No. of Detectors 2
See Plan for Location
L RESIDENTIAL BUILDINGS
Number of Bedrooms \
~
Number of Bathrooms
Full ~ Partial
5. IDENTIFICATION - To be completed by all applicants
Name
Mailing address - Number, street, city and state
Zip Code
Telephone No,
Works Compensation Insurance Certificate or Affidavit must be submitted with this application.
I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to make
this application as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Bet 141 f\;),,1tJrt fI\~
1,
Owner or
Lessee
2.
Contractor
3.
Contact Person
Signature of applicant
Prlh rn ~oa
Address Telephone #
f {).BDi tIE 8'~et (.SD8 )27>7-u'lJ2l
J mtT 025 ,.If-
Print name ~(\Q ~~e
6. PLAN REVIEW RECORD - For Office Use
Plans Review Required
HISTORIC DISTRICTS COMMISSION ~/ (9/ ",/6/03
SEPTIC ' ,
SEWER
WATER WELL COMPLETION REPORT
CONSERVATION COMMISSION
FIRE CHIEF
OVER-THE-ROAD (Board of Seiectmen)
ROAD OPENING PERMIT (DPW)
PLUMBING
ELECTRICAL
DO NOT WRITE BELOW THIS LINE
7. VALIDATION
FOR DEPARTMENT USE ONLY
Building Use Group
Permit Issued
Occupancy Load
Building /~ 7 g.)- Census No. ~1~
Permit Fee o ,t,(
Approved by:
Date of Issuance of ~4~~ sX2~.J
Certificate of Occupancy ,
Building Commissioner