Home Business Application

ZONING BOARD OF ADJUSTMENT

21 ACADEMY AVENUE

ATKINSON, NEW HAMPSHIRE 03811

Tel. (603)362-5761 – FAX (603) 352-5305

HOME BUSINESS APPLICATION AND/OR RENEWAL SURVEY

Introduction

This survey is intended to serve as your application and/or renewal of your home business permit. You are required to answer all questions completely and accurately in order to provide the ZBA with the information necessary to consider your application and/or renewal. If a questions does not apply, so indicate Leave no spaces blank. If you feel more information is necessary in order to accurately answer any questions, you should attach whatever supplemental information is needed.

In order to guarantee that your application is reviewed at our next regular public meeting, you should file it at least fifteen (15) days, for new home business application and five (5) days for a renewal prior to the meeting date. The board will review your application and notify you in writing as to whether it can be approved as filed. If the board is not able to approve the application as filed, you will be notified and invited to discuss your application at our next scheduled meeting, providing the filing requirements listed above are met.

If this is a renewal application, indicate the date of the original approval:_________

If you have any questions, please contact the Code Enforcement Office at 362-5761.

General

Name of Applicant__________________________________________________

Property address_________________________________Map_____Lot_______

Owner of Record___________________________________________________

Name of your business______________________________________________

Daytime Phone___________________

Name of any other business operated from this location:____________________

Description of proposed use-showing justification for a Special Exception as specified in the Zoning Ordinance, Article IV, Section 450. Accessory Uses: Home Occupations. Describe the nature of business, its operation and activities:

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

Changes (renewal only)

Describe all changes to the property or business made within the last two years. Include building, grounds, parking, signage, addition of vehicles, growth of the business, etc.:

________________________________________________________________

________________________________________________________________

________________________________________________________________

Physical information

1. What percentage (%) of your buildings, including storage space, are used for your business_____________.

NOTE: if greater than 20%, attach a dimensioned sketch of entire floor plan. Indicate the areas used for business.

Indicate the dimensions of your sign (attach a diagram if needed):_________

List all chemicals, materials, and equipment used or stored in the operation of

this business:_____________________________________________________

________________________________________________________________

________________________________________________________________

Indicate any physical evidence visible, audible or otherwise noticeable to any abutter resulting from equipment or material used, or activities performed, in the operation of this business:______________________________________________________

Employee information

List every person (other than customers) involved in the business on the premises. Include yourself, any family members, subcontractors, etc. Attach another sheet if necessary:

Worker Position Relationship (if any) Hours per wk

1 ______________ ___________________ __________

2 ______________ ___________________ __________

3 ______________ ___________________ __________

4 ______________ ___________________ __________

Vehicular information

List all vehicles registered to you or to anyone else at this address:

________________________________________________________________

________________________________________________________________

List and describe all vehicles, trucks and other conveyances parked on the property at any given time:________________________________________

______________________________________________________________

______________________________________________________________

Give a description of the nature and volume of vehicular traffic related to your home business during a typical day. Indicate the size of delivery vehicles and the number of trips per day. Be sure to include visitors, delivery trucks, customer vehicles, etc.:___________________________________________

________________________________________________________________

________________________________________________________________

Approximate number of daily automobile visits to and from the property _____

Describe the worst case traffic you would expect:_______________________

Describe your off street parking:____________________________________

________________________________________________________________

Signature & Date

I hereby apply for a home business and/or renewal permit as described and regulated by the Atkinson Zoning Ordinance. I also certify that the information contained in the above application is true and correct to the best of my knowledge, and represents an accurate and complete description of my home business.

Applicant signature Date

--------------------------------Do not write below this line. For Town use only------------

Date of Zoning Board of Adjustment meeting__________________________

Result of Board’s review:__________________________________________

_______________________________________

Chairman, Board of Adjustment Date

Revised 6/6/00