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Town of Masee <br />16 Greotj%ck 1�ood,Xorlh <br />A I h Allaslipee, Mossochusetts 02649 <br />PETITION FOR SPECIAL PERMIT <br />Per MGL Chapter 40A §9 and Town of Mashpee Zoning By Laws of 1987 <br />Date � -10 -Z(>1q <br />Print <br />Property Address UMO�1-4-1 1ZC>A2 <br />Map BO Parcel <br />N <br />Petitioner 1ZySS(ZT L t Phone <br />Zoning District T- \ <br />Email 12-CA-TAJA I A (P W I C 14 AU V-N ti'L CO-1 <br />Owner's Name 14, A VA v 1,L Phone <br />Is this property within the Precontact or the Postcontact Archaeological Sensitivity areas DYES Afqo <br />Applying for (Check appropriate box(s)): <br />[]Accessory Apartment []Commercial E]Sign El Bed and Breakfast El Private Non Profit <br />[]Hospital/Nursing Home []Outdoor Recreation El Indoor Recreation El Raze and Replace <br />E]Lumberyards/Landscaping El Automotive Repair [] Drive ln El Wireless Services ElMedical <br />Uses E]Kennel [] Retail Sales DEating Establishment ther <br />BRIEF DESCRIPTION 15 CC- y- t tL C A IAC- fg-VM1 —I 4,k A MAi'L�TQAOA <br />Owner's Signature or letter <br />Petitioner's Signature <br />Mail certified copy of Decision to: 3,6-V 6OUTIA G-T'4VGT HM41 rV-et MA <br />Scheduled Date <br />Rev. 1118119 <br />SEP 13 20A <br />RECEIVED IBY—�o <br />a <br />