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Date Created: 12/22/15
C I T Y O F G A R D N E R ZONING BOARD OF APPEALS APPLICATION The undersigned hereby appeal(s) to petition the Zoning Board of Appeals for permission or authorization to: An application for the same having been submitted to the Building Commiss ioner and denied by the Building Commissioner for the reasons stated in his letter attached hereto. The reasons specified by the undersigned as a basis for granting the petition or request in the appeal herein are hereinafter set forth in the answers to questions numbered 7, 8 or 9; and further, the undersigned submits under oath the information and representations contained in all answers to questions for consideration by the Board in its determination of Appeal or Petition herein. 1. What is the name and address of each Appellant or Petitioner? 2. State the street address or other sufficient description to readily identify the land or building which is the subject of your Appeal or Petition. 3. What is the name and address of each holder of legal title to t he land which is the subject of your Appeal or P etition? List each name exactly as it appears in the Deed or Petitionplease have available such Deed or a copy. BOOK PAGE 4. If thee Appellant(s) or Petitioner(s) have any knowledge of prior Appeals or Petitions which concern the land or buildings involved in the Appeal or Petition herein, please describe such other Appeals or Petitions and the dates thereof as nearly as possible. 5. On the reverse side of this page, draw a sketch or dia gram of the land and building which are the subject of or affected by your Appeal or Petition herein, observing proportions as nearly as possible and indication accurately the diagram of North. Also, it is very important that you showsuch sketch or diagram the following: (a) Metes and bounds of said land. (b) Adjoining streets and other named & identified landmarks. (c) Dimensional layout of all buildings. (d) Distances said building(s) are set back from boundaries and apart from each other. (e) THE EXACT DIMENSIONS, SETBACKS AND SPECIFICATIONS OF ANY NEW CONSTRUCTION, ALTERATIONS, ADDITIONS OR INSTALLATIONS WITH WHICH YOUR APPEAL OR PETITION IS CONCERNED. 1 6. If pertinent to your Appeal or Petition, describe the topography, general conditions of terrain, an d the sub surface conditions of the land involved. 7. If your Appeal is base d upon a contention that the Building Commissioner erred in the interpretation of the Zoning Ordinance as related to your request herein, use the reverse side of this page to specifythe alleged error and the reasons for your contention. 8. If your Appeal or Petition is made under the provisions of SECTION 11, #1180 of the Gardner Zoning Ordinance relating to Special Permits, use the reverse side of this page to state in complete detail your reasons for concluding that the latter section is applicable to your Appeal or Petition. Be certain to include floor and lot areas. 9. If the basis of your Appeal or SECTION 4, #420 Petition is a request for a Variance within the provisions of, and in conformance with Chapter 40A, Section 15 of the Zoning Enabling Act of Massachusetts, then use the reverse side of this page to specify as follows: The special conditions affecting the land or building involved in your Appeal or Petition which do not affect generally the Zoning District in which such land or building is located. Having specified the special conditions required above, please state exactly how such conditions, under strict enforcement of the Zoning Ordinance and re fusal by the Board to grant the Variance which you request, would involve a substantial hardship, financial or otherwise, to the Appellant(s) or Petitioner(s). By way of anticipation, comment in regard to any objections to the granting of your Appeal or Petition which may be based on the grounds that the Variance which you have requested would be substantially detrimental to the Public Good. By way of anticipation, comment in regard to any objections to the granting of your Appeal or Petition which may be based on the grounds that the Variance which you have requested would substantially derogate from the intent and purpose of the Zoning Ordinance, that is, to promote the general welfare of the City to protect the health of its inhabitants, to encourage the most appropriate use of land within the City, to lessen congestion in the streets, to avoid undue concentration of population, to reduce the hazard from fire, and to provide adequate light and air to buildings, by regulating the location, use and height of buildings and the spaces about them. 10. Kindly give any additional information you consider important in the determination of your Appeal or Petition. 11. State the name and mailing address and telephone number of each attorney, agent, or ot her representative of the Appellant(s) or Petitioner(s). ________________________________________ Telephone #(s) Signature of Applicant ________________________________________ Signature of Applicant 2
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