23D-136 (3) qv
Date Filed 4..
((���"r;�:� File No.
ZONING PERMIT APPLI�2# '�o-N'-M 1 t7_. 2)
1 . Name of Applicant: Lout s g N R 4-7 ,= y LA
Address : y,,vcitz_f;y 57-- Telephone: 3 S y - & ,66 .
2 . Owner of Property: 4-0r.4/ % R 13g 4 -ze A-
Address : 3 3 N , avci < L� y ST Telephone : .may- 53-66-.
3 . Status of Applicant: ✓wner Contract Purchaser
Lessee Other (explain: )
4 . Parcel Identification: Zoning Map Sheet# 23 t Parcel# 6(9 ,
Zoning District (s) (include over{ �-ays) USA
Street Address 513 W-,4,011 - . ,
Required
5 . Existing Proposed by Zoning
Use of Structure/Property
(if project is only interior work, skip to #6)
Building height
oBldg. Coverage (Footprint)
Setbacks - front j r i5
- side L: R: L: R: z/ 1 F- y, 1-- LI ,
- rear 3 4 ,
Lot size lg3-‘9v flZ
Frontage /M /
Floor Area Ratio
%Open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs .
Fill (volume & location)
6 . Narrative Description of Proposed Work/Project : (Use additional sheets
if necessary) /1\`
1,0 c (`. a. , ,, C D.,_ -fix ail C' z l
Tn, - a '`.
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 knowledg .
Date: / pR, L al.6 / 99/ Applicant's Signature : 0 , ,_A____R �,6t�--
THIS SECTION FOR OFFICIAL USE ONLY:
Approved as presented/based on information presented
Denied as presented--Reason:
Special. Permit and/or Site Plan Required:
F'n ing R u ' red: Variance Required: 3, 71 ry
fa/14// /S gna _ of B specter
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.
I"'1.)_