18D-004 (35) qt 509 4 9
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Date Filed 0025 28 File No.
ZONING PERMIT APPLICATION ( §10.2)
. Name of Applicant: L= vELyc) {)40(
L Address: /a) /p ,e Telephone: -5 a y
`2 j
. Owner of Property: , C --v►c
- 4 , Y 1 f� `yc
(� Address: /06 0/0x4f-K-ALI Telephone: ,, gz 44/17
3. Status of Applicant: Contract Purchaser
Lessee Other (explain )
4. Parcel Identification: Zoning Map Sheet# /617 Parcel# i t ,
Zoning District(s) (include overla ) drT
Street Address /DD 726-,( . ,
Required
5. Existing Proposed by Zoning
Use of Structure /Property lei,
(if project is only interior work, skip to #6)
Building height
oBldg.Coverage (Footprint
Setbacks - front
- side L: R: L: R: -
- rear ,/
. Lot size %
Frontage. j
Floor Area Ratio
%Open Space (Lot area minus %'-
building and parking)
Parking Spaces %
Loading
Signs .
Fill (volume & location)
6 6. Narrative Description of Proposed Work /Project: (Use additional sheets
i if nec e s s ary ) faL,_,¢.A,e_ , - ,4-e- - 1--r--- o f �
( zm .�A,c - ti �.e _ ,1) -c.� -E LF -- ( , d ei 1 -''"
U
Y
7. Attached Plans: Sketch Plan Site Plan
. 8. Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowle. e.
Date: Applicant's S ignatur - . $ ,GcL a
G
THIS SECTION FOR OFFICIAL USE ONLY:
? ; ... ! • QVV,' as presented /based on information presented
- ;presented -- Reason:
'' ` Permit and /or Site Plan Required:
• ding qu red: Variance Require : r
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or y 777y
gn • - ': f Bui l • - nspector Da
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning requirements and obtain all required permits
from the Board of Health, Conservation Commission, Department of Public Works and other applicable permit granting authorities.