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Ton o _ aslee <br /> 16 Great 1%ck l(aftc7<,Yoolz <br /> Mashpoc lWasaachusetts 0w649 <br /> PETITION FOR SPECIAL PERMIT <br /> Per MGL Chapter 40A §9 and Town of Mashpee Zoning By Laws of 1987 <br /> Date Zoning District <br /> Print <br /> Property Address <br /> Map Parcel <br /> Petitioner '`�� hyl+ Phone -51)b 5-;e-1 f z"z�,o <br /> Email �� { . crry <br /> Is this property within the Precontact or the Postcontact Archaeological Sensitivity areas OYES ❑NO <br /> Applying for (Cheek appropriate box(s)): <br /> ❑ Accessory Apartment ❑Commercial ❑Sign ❑Bed and Breakfast []Private NonProfit <br /> ❑Hospital/Nursing Home Ll Outdoor Recreation ❑ Indoor Recreation NrDocks <br /> ❑Lumberyards/Landscaping ❑ Automotive Repair ❑Drive In ❑Wireless Services <br /> ❑Medical Uses ❑Kennel ❑Retail Sales ❑Eating Establishment []Other <br /> BRIEF DESCRIPTION CT <br /> G' r)-' del `�O tA//v 131)lq-r g h.."M <br /> Owner's Signature or letter <br /> C. COLLINS <br /> Petitioner's Signature Town Manager <br /> Mail certified copy of Decision to: <br /> . i . • . . i 1 . Y . . . • . • . • . • . • . Y . R . • . i . . . • . Y Irk R IIIYYY N i1A1011 ■ <br /> MASHPE�J"ttCEMW <br /> Scheduled Date �e-e 1 DATE STAMP <br /> AUG 2 6 2016 <br /> Rev. 3/06/.15 RECEIVED BY Lj- j <br />