25A-046 (15) d'CcV.y �L
i
Date Filed v 000 File No.
ZONING PERMIT APPLICATION (§10 . 2)
I . Name of Applicant:
address : �t ;�� 1;-_ �.1t 44i. a. Telephone : 63 4 _ � _
2 . •I ier of Property: _
tiudress : Telephone: _
3 . Status of Applicant: ✓Owner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet#—•-1-5-A Parcel# c,,!. ,
Zoning District (s) ( include overlays) G.r
Street Address r _
Require
5 . Existing Pro Dosed bv Zonin_;�
Use of Structure/Property ie&o4L 4Lg . f:�Z65c.v�x�
(if project is only interior work, skip to #6)
Building height '
-B1dg. Coverage (Footprint) ?" 7• _
Setbacks - front
- side L: c1'_R: Vic' L: 6e) R:
- rear .)�. , n'
Lot size 6(2-7,15-7
Frontage Zcc., •7
Floor Area Ratio -6
%Open Space (Lot area minus
building and parking) % Z& i
Parking Spaces (v I
Loading
signs -
Fill (volume & location)
6 . Narrative Description of Proposed Work/Project : (Use additional iaeets
if necessary) o r,,vg :, �v, C fi -,,:2 Fr . l%ff
14 40,0 l 1[)i�l
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 knowledge.
Date: tC1 Appl icant' s Signature
THIS SECTION FOR OFFICIAL USE ONLY:
pproved as presented/based on information presented
ill Denied as presented--Reason:
Special Permit and/or Site Plan Required:
-Finding squired: 1j, /� Variance Required:
Signatur off_ sng--Inspector Date
NOTE: Issuance of a zoning permit does not rolieve 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 authoriifes.