29-509 yam ! •; -
Date Filed 0 0 2 7 2 0 File No.
ZONING PERMIT APPLICATION
Applicant:of a ✓)�pC 1r'
Address: w y e
Telephone: -
21. Owner of P operty: .
Address: Z' / Telephone: - 3
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain: of n )
4 . Parcel Identification: Zoning Map Sheet` 2 1 Parcelif ,
Zoning District(s) (incl lays L(J2,G1
o
Street Address ,
Required
5. Existincr Proposed by Zoning
Use of Structure/Property
(if project is only interior work, skip to ##6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front 3b�
- 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 & location)
6. Narrative Description of Proposed Work/P oject: (Use additional sheets,
if necess ry) a a T• i x 61"',1 "s t
3. W v' i rY1
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 knowled e.
Date: Tun e- a '74 Applicant's Signature..
THIS SECTION FOR OFFICIAL USE ONLY:
,pproved as presented/based on information presented
y' enied as presented--Reason:
Sp cial' Permit and/or Site Plan Required:
di Re ed: Variance Required C '
9CY
4Sgnatul�d lding Inspector at
NOTE: issuance of a zoning permit does not rollove an applicant's burden to comply with all zoning raquiroments and obtain all requirod permits
from tho Board of Hoalth,Consorvation Commission,Dapattmont of Public Works and othor applicable permit arantina nuthorMos.