HomeMy WebLinkAboutApplication - 250 BRIDLE PATH 9/1/2005 Town of North Andover Planning Board
Application for Watershed Special Permit
Please type or print clearly.
1. Petitioner:- �i FZ Ki)CHARZ- VK , T-)--', PEF-(.& TRIJ' ST
Petitioner's Address: f Fps`, 17.�, 7l'
Telephone number: q73—
2. Owners of the Land: 1-4 Lf-A)A-\I & J(-f-9 A C 2,V TQ'I R�-
Address:— PO 1701-, LLVE-44-, -,/I/Y--! 64,53 -- 1761
Number of years of ownership: y q
3. Year lot was created:
4. Is the lot currently on septic or sewer? -5-4e we .5 e7�V,d C /-I V I(.(116 6�-
If on sewer,please provide date the sewer connection was completed:
5. Description of Proposed Project:
L S 7-P-(2 C L7 L)
_A) VV a,/
A J-9 rJ 1)1 i C 7- Ze)6JC— OF THE W47-F-109YED Pe,-R:V7-164-1 1)/S7e/tT
100 FoC&V-1 A LErSbOle-CE)
6. Description of Premises: 1 E Ap,041)L V /14!!J F-- L C To-
Au 000- /✓
C 0,111 0 14)1 7-,J 91J V 9TI�-r--/L AQ 74-
7. Address of Property Being Affected 1-07" Zo/ Fl /h- L FqTlj
Zoning District: P
Assessors: Map: 0,4 Lot# 1132-
Registry of Deeds: Book#: Page#:
S. Existing Lot:
Lot Area(Sq.Ft) BuildingHeight
Street Frontage: Side Setbacks:
Front Setback: [=-1 Rear Setback: 3.r,> f
Floor Area Ratio: Lot Coverage:
9. Proposed Lot(if applicable):
Lot Area(Sq.Ft) Building Height 73
Street Frontage: Side Setbacks:
Front Setback: Rear Setback: C-)
Floor Area Ratio: Lot Coverage: <
L)
C:)
10. Required Lot(as required by Zoning Bylaw):
Lot Area(Sq.Ft) r !, t Building height °? °.-
Street Frontage: i Side Setbacks: _ L=
Front Setback: .fin Rear Setback:
Floor Area Ratio: -'_'i•'-- Lot Coverage:
11. Existing Building(if applicable):
Ground Floor(Sq.Ft.) #of Floors:
Total Sq.Ft. Height:
Use: Type of Construction
12. Proposed Building:
Ground Floor(Sq.Ft.) /,6 5 S r° #of Floors: f a
Total Sq.Ft. _ v > 4 Height:
Use: ltiCy i ` fi: Ji l.' i !ty.,'t! Type of Construction V.."C'>(C`
13. Has there been a previous application for a Special Permit from the Planning Board on these
premises? r -�, If so,when and for what type of construction?
14. Section of Zoning Bylaw . that Special Permit Is Being
Requested ` . 1 r C- ct 5 60i111-;7/2-uc7—"r;: 6V 1e—e a-1A, i, P 7
-—
15. Petitioner and Landowner signature(s):
Every application for a Special Permit shall be made 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
responsibility ofthe petitioner to fiuvish all supporting document-tion_ith'this app lea on.
The dated copy,of this application received by_the Tovrn 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 Ruleis and Regulations-may result in a dismissal by the Planning B oard
of this application as incomplete.
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f
Y—J )VO \_ \Petitioners Si gn atu re.
j
Print or type name here:_ h11- f f i i ; F fC-
J
Owner's Signature: i t tV�t� ;_ f / z,
Print or type name here: Henry Kucharzyk
—PO Box 1701
Lowell,MA 01853-1701 _
6T;
16. Please list title of plans and documents you will be attaching to this application.