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Appeal Form

TOWN OF HOLLAND
Variance/ Special Permit Application

This Form To Be Filed with the Town Clerk with Fee Payment of $125.00

Date ______________________

TO THE ZONING BOARD OF APPEALS:
        The undersigned hereby petitions the Board of Appeals to vary the terms of the Zoning By-Laws of the Town of Holland

in the following respect:     due to a ______non-conforming lot
        or          ______other reason please explain:


Please give Chapter and Section of the Zoning By-Laws for which a variance is requested:


or any limitation, extension, change, alteration or modification of use, or method of use as may at the hearing appear as necessary or proper in the premises.

For the following property:  Street_____________________________________________________

                             Map & Lot Number _______________________________


State Briefly Reason for Variance
Attach Pertinent Plans & Drawings















Property Owner____________________________________________

Petitioner__________________________________________________

Address___________________________________________________

              ___________________________________________________

Phone______________________________________________


 
Town of Holland 27 Sturbridge Road, Holland, MA 01521
Phone: 413-245-7108 Fax: 413-245-7037
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