HomeMy WebLinkAboutApplication - - 350 GREAT POND ROAD I
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PLANNING DEPARTMENT
Community Economic Development Division
Special Permit— Watershed �Permit'Application,
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Please type, r print clearly. No n,Y,
1. Petitioner:
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Petitioner's Address-.,. 00
2. Owners,of the Land-
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Telephone number&email:
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Number years wnership.
ell
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3.Year lot was created:
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. Is the lot currently on septic or sewer"
If ser, iIs provide
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5. Description of Proposed Pro'ect: 64' A)AI'Ve--
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6. Description of Premises:
Address f Property Being Affected.. P
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,ZoningDistrict:
Assessors Maps Lot
Registry Deeds: Boob U
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8., Existing Lot:
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Lot Area (Sq. Ft): 41f, Building Height:
Street Frontage: Side Setbacks
Front Setback: Rear Setback
Floor Area Ratio: Lot Coverage:,
9. Proposed Lot it applicable):
Lot Area S . F : Building H eigIt
Street Frontage: Side Setbacks.:
Page 1 of 2
120 Main Street, l nning Dept., North Andover, Massachusetts 5
Phone 978.688.9535 Fax 978.688.9542 Web www.north andoverm
Front Setback,.,, Rear Setback:
Floor Area Ratio: Lot Coverage:
10. Required Lot(as,required by Zoning Bylaw):
Lot Area (Sq. Ft): Building Height:
Street Frontage: Slide Setbacks:
Front SetbaclI Rear Setback:
Floor,Area Ratio: Lot Coverage:
11. Existing Building (if applicable):
Ground Floor(Sq. Ft.): #of Floors,:
Total Sq. Fit.: Height:
Use: Type of Construction:
12. Proposed BuildIing.-I
Ground Floor(Sq., Ft.): #of Floors:
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Total Sq. Ftp Height.
Use: Type of Construction:
13. Has,there been a prev M pplication for a Special Plermit from the Planning Board on these
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L 4 If so,when and for what type of construction? 2�,'? '10A W'I em ? I �M I
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14. Section of Zoning Bylaw that Special Plermit Is Being
Requested AR,b C &w i e X ILI
15. Petitioner and Landowner signat inure(s):
Every application for a Specia,l Permit sh 111 on this form, which is the official form of the
Planning Board., Every application shall be filed with the Town, Clerk's office. It shall be the
responsi,"bility of the petitioner to furnish all supporting, documentation, with this application., the
dated copy of this application received by the Town Clerk or Planning Office does not absolve the
,applicant from this, responsibility. The petitioner shall be responsible for all expenses for filing and
legal notification., Failure to comply with application requirements, as cited, herein and in the
Planning Board Rules, and Regulations may result in a dismissal by the Planning Board of this
application as incomplete.,
Petl�ioner's Signature�
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r1c,110c' k Q IN rint r t oyp e name here: /I#+e
Owner's Signature:
Print or type name here: H, f 5 til"j)b I
16, Please list title of plans and documents,you will be attaching to this application,
Page 2 of z
120 Main Street, Planning Dept., North Andover, Massachusetts 01845,
Phone 1978.688.9535 Fax 978.68,8.9542 Web www.northandoverma.gov