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16 Great�4{ecor�rfbrcli <br /> Afashpee,lWasscchUsetts 0.?449 <br /> 4 <br /> PETITION FOR A-I0R. j_F'IC�WX <br /> Date <br /> Zoning District A"--. <br /> Print <br /> Property Address <br /> Petitioner . E .. <br /> Phone _ <br /> Email <br /> Owner's Name P 7, Phone > " <br /> ZBA Original Docket Number 12 0�.;? ,. 3 <br /> Projectisa: ❑Deck ❑Addition DHouse 146ther <br /> Proposed Modification � � ` <br /> Owner's Signature or letter <br /> Petitioner's Signature . <br /> fi <br /> Mail certified copy of Decision to: <br /> . Y hewn I . • wry X . • . . . X .t i ■ . . i . . X . a v Z . Y . i . N . • d ■ . i ' <br /> TOWN CLERK <br /> Scheduled Date '4,$ MA�WWN CLERK <br /> MAY 2 5 2018 <br /> RECEIVED BY_4 <br /> Rev 2/12/15 <br />