17C-293 i
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002775 33
Date Filed ( a File No.
ONING PERMITp APPLICATION
1 . Name of Applicant: Fl orcv�cc: f-a�w� c data+�wc,
Address: .5 - r-(.,feV%CL. mpt Telephone: 58(( -3-T z3
2 . Owner of Property': ,J o E?oh
Address: _CctP_S McoaoA, N'kam Telephone: SRb-oi5�.
3 . Status of Applicant: -,"'Owner Contract Purchaser
Lessee Other (explain )
4 . Rarcel Identification: Zoning Map Sheetf ILL Parceli__A
Zoning District(s) (include overlays)
Street Address ,
Required
5. Existina Proposed by Zoriin
Use of Structure/Property
(if project is only interior ork, skip to #6)
Building height
%B1dg. Coverage (Footprint)
Setbacks - front
— side L: R: L: R:
- rear
Lot size 5
Frontage.
Floor Area Ratio 00
%Open Space (Lot area minus
building and parking) to 'Zo
Parking Spaces i v
Loading ;i x
signs
Fill (volume & location)
6 . Narrative Description of Proposed Work/Project: (Use additional sheets
if necessary) elate- s I g v ow Side o bv�lIt' u krill i rov,t5 AIDC41n
w�o�Q1c s�.
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: I�( (� Applicant's Signature:2 G--S /Vt
THIS SECTION FOR OFFICIAL USE ONLY:
proved as presented/based on information presented
_25anieq as presented--Reason:
Special• Permit and/or Site Plan Required:
n ng R quire d: Variance Required:
'Rghatufbof Building n eetor at
NOTE: Issuance of a zoning permit does not rciiave an applicant's burden to comply with all Zoning roquiromonts and obtain ail requirod permits
from tho Board of Health,conservation commission,Dopaitmont of Public Works and othor appiicabio permit granting authorlllos.