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5p_0,g_ q1 <br />"`" Town of Mashpee <br /><I I -% .4 <br />MASHPEE ZONING BOARD OF APPEALS 16 Great Jfeck TOad Xorth <br />AUM PETITION FOR A SPECIAL PERMIT Mashpee, Massachusetts 02649 <br />Under Massachusetts General Laws Chapter 40A §9 and <br />Town of Mashpee Zoning By-laws of 1987 <br />To: Mashpee Zoning Board of Appeals Date: 0z124/03 <br />The undersigned petitions for a Special Permit from the Mashpee Zoning Board of <br />Appeals, as required by pertinent sections of the Zoning By-law of 1987: <br />Petitioner: JaHN _211-1c411.0 41`2 �26g2r C2cGE �sv8� `-177- 12v7 <br />(Full name) (Address) (Telephone #) <br />Property Owner: ,'"" as above <br />(Full name) (Address) (Telephone #) <br />Location of Property: 4147/ 34?&41Cr C2`Lr Zoning District R 3 <br />(House Number and Name of Street) <br />Assessor's Map/Parcel Number: Map # 96 Parcel # ! 0 16 <br />Dimensions of Lot: 158 / u 17o / Area 25 Inc) <br />(Frontage) (Depth) (Square Feet) <br />How long have you owned premises? grace 1976 <br />State present use of premises: 2Cs d4,f.al w% hce.)Sed prem a4d doct'. <br />State proposed use of premises: as e4ovr rcplau15 28 of X,1,47 daGta <br />ry 4 {fired <br />What section(s) of the Zoning By-laws requires the permit you seek? <br />171-4 25. L . 9 <br />Have you submitted plans for above to the Building Department? Yea <br />Hearing Date set for: <br />I do hereby state that I have conferred with the Building Commissioner on and it <br />has been determined that this project X does does not fall under the <br />jar-L�diction of the Conservation Commission. <br />P tionerZs'Signttyre7 G�7 <br />' FgGNOv>'W/ CNGIN <br />SQ• �rAgLQ b"KIVC. <br />CfoUi/J <br />01 Agent's Signature/Address/Phone # <br />