HomeMy WebLinkAboutBuilding Certificate l' L F 5 BUILDING DEPARTMENT
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'F?. '��j C�.` "146 Route 2 . Sei':,th `'S a mime-, , �7'5+�026`4 ' SEP 19 2019
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ZONING DETERINIEN.ATION FOR BUSINESS CERTIFICATE ..PP[jC_'Y o Odd
.The .. a with _ . -'
L e purpose of this form to deter ;re whethery u busessC3ailies the E^=is of\'c" oith
Zoning, -�qi. The applicant shall complete the top sector} of this form and file it with ti : Bt*rnu yyi-E d
ram. .
1 Department/Board xe„3 1 �e determination, i ' be 'o,?
Once the )i?ii1��,:=�T of Health has made a t'il: t __ ,*`�r'13�t� �
Q Town
c_iL a. it i� the
6 o1:n Clerk.
The Building Department will render a determination ba :i on The following factors: ( ) The ii.a .=s..•.' e,
z-ttilt:,t' (' The_r._ _` inct which .eerow �'is `ef? tef '3} w5~_S'a e?� -•_s4 t
"1� ,7 (•]) „J:tui` �-_i i � S'ii S to: .emu>..�. :i_i. I'C L-'.r-.C2',�,. i2�e_...•^• >r21x
e, ief fr the -�Board !- _S
Table
202.5(1l-rid
( ) °•c'iGii_S'or.ir€r ..o�tir:` r =t�j�t:-e,+ Li'•=ec`::.` .�tC..of:_ �G:,
Date 1 Applicant's contact number $�c" �l60 .4(c 1)
Basin ss Addr es °I f-? MAr/7 S i S .y,4Crncu rht ,�'1A- GoZl.t'(�t(
Name of ppliic t 00\C Foo,4 Tnt' .
DE e 'N 14-rr)ovvA oct wy OJz�7)
Mp%1i igAzdresS
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Description of Business Actih ity Z Chet^ " �7�0P
rsA 61'Lt1M
The ap 1'-('%iot ackne-Fledges that a determination will l be mad_by the Building Department based on the
on d and changesi. business - s^ ac F7 iry will'require
information 1?r�S�'it:(.d. this date any the ;.ire and/oradditional approval. Failure to do so may result in the revocation of the Business Certificate and/or
' Enforcement.rce it' ,a_ to ti e cha eare non-compliant.
nt.
���-ej�rlat?E,rs�_�t5�iZ�i _a=e_ty should a determined izli==d i=:ci i iE' S '�i' i1R-7�L_-4__"
,2 Applicant's Signature i 1 -11_ Date
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BU11_,DG/NRALTFI DE'P A.RTMENT DETERNUNATfON
(office use Dint')
Comments ,zT/ .„ub
Disapproved
Reason for Disapproval
Building . fhcial's •l� s��
Simature Date