22D-012 (3) r.i,i
Date Filed ,j i /4 /9s5 File No.
ZONING PERMIT APPLICATION (510.2)
1. Name of Applicant: J eTpBAre P 7 EVFLY.Y r4 ;w,anr
Address: / Air 4 „st nl sT- exc#9 n' Telephone: -
2 . Owner of Property: ,
Address :_' _ Telephone:
3. Status of Applicant: X Owner Contract Purchaser2--
Lessee Other (explain:
4 . Parcel Identification: Zoning Nap Sheet! ,2?,-,2a Parcel#+7,r;'t,7
Zoning District(s) (ing ude. opterlays) pRp WSP .._
Street Address x i& - yiP
0 Required
5. Existing Promosed b Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
eBldg. Coverage (Footprint)
Setbacks - front
- side L: R: L: R:
- rear --...... ....
Lot size _
Frontage.
Floor Area Ratio
%Open Space (Lot area minus
building and parking)
Parking Spaces _
Loading
Signs
Fill (volume s location)
6. Narrative Description of Proposed Work/Project: (Use additional sheets
if necessary)_ r.b.,htt,
. - (c1.._y
7 . Attached Plans: Sketch Plan Site Plan
S. Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
Date: afI(f'fic __ Applicant' s Signature: may...- 0-4.m.44-
/ THIS SECTION FOR OFFICIAL USE ONLY:
__Approved as presented/based on information presented
'Denied as presented--Reason:
Special' Permit and/or Site Plan Required://.ti
1' hd ng ' -, `iijed: Variance Required:
• ?%/ _ '4 215
S' gna' r- o' Bulldxr ._ Spector *a -
NOTE: trsuonco of a zoning permitdoes not tellave an applicant's burden to comply with an zoning roqukoments and obtain alt required por mhs
from the Hoard of Health, Consorvo(lon Commission, Doparlmonl of Public works and alio/ opplicablo permit granting outhotMos.
ICI J_