23A-017 (8) r}0 42 20
Date Filed 2- File No.
ZONING PERMIT.' APPLICATION (§10. 2)
1 . Name of Applicant:
Address: /l477�> IAj(2- bt ��(G}L 1��� _/tl ! e�Telephone
2 . Owner of Property: .
Address: - l0 P/Jfi _ E y Telephone:
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explaini�/.LL =mac_ )
4 . Parcel Identification: Zon' ng Map Sheet# r�3 r Paroel#��,
Zoning District(s) (include o e ays) �-
Street Address LO r
Required
5, Exi9tin Proposed - bv Zoning
Use of Structure/Property
(if project is only interior wor ip #6)
B ilding height 4 -(D 1?o
oB1dg . Coverage (Footprint)
Setbacks - front WET
- side L:_f5R: L: R:
- rear
size —
Frontag'e
Floor Area Ratio -
oopen Space (Lot area minus
building and parking)
Parking Spaces - -
Loading — -
Signs - -
Fill (volume & location)
6 . Narrative Description of Proposed WorYLOZ.-
ct: (Use additional sheets
if necessary) �, a� r
7 . Attached Plans: Sketch Plan J Site Plan
8 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
Date: 5 VC7, Applicant's Signature:
THIS SECTION FOR OFFICIAL USE 61- -Y
Approved as presented/based on information presented
Denied as presented--Reason:
S cial' P t and/or Site Plan Required:
in ng q i d: �, �-- variance Required'
gnat r of Bu� ld�n ector a
NOTE: Issuance of a zoning permit does not reffave an applicant's burden to comply wiU,all zoning requirements and obtain all required permits
from tha Board of Health, Consorvation Commission, Department of Public Works and otl,or applicable permit granting authoritlos.