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BOARD OF APPEALS
(617) 898-4932
(617) 898-1096
8:30AM-5:00PM (Monday-Thursday)
File Plans With This Application
Must be Filed In Triplicate and All Signed
Plans Must be Certified
$100.00 APPLICATION FEE
DATE: ____________
LOCATION OF PROPERTY: _________________________________________________________________________
Number and Street Section of Town
SECTION _________ BLOCK ____________ LOT ___________ DISTRICT IS ZONED FOR __________________
TYPE OF STRUCTURE: _________________________ _______________________________________________
Existing Proposed
OWNERS NAME: __________________________________________ HOME # ____________ WORK # __________
OWNERS ADDRESS: ________________________________ WHEN DID YOU ACQUIRE PROPERTY: ______________
HAS APPLICATION BEEN FILED AT BUILDING DEPT. __________ ________ ________
YES NO CASE #
HAS ANY PREVIOUS APPEALS BEEN MADE: _______________ _________ _________
YES NO DATE
________________________________ ________ _______
IF ANSWERED YES, RELIEF REQUESTED GRANTED DENIED
SECTION OF ORDINANCE FOR WHICH RELIEF IS NOW REQUESTED: _____________________________________
____________________________________________________________________________________________
REASONS FOR REQUESTING RELIEF PERTAINING TO BYLAWS & DIMENSIONS & STATE WHAT YOUR PLANING TO DO: ______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
ATTORNEY:_____________________________________________________________________
SIGNATURE OF OWNER (S): _______________________________________________________
APPLICANT (S): ________________________________________________________________
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