HomeMy WebLinkAboutAdmin Review 6.16.2026 g YAK
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OFFICE
bdirienzo@yarmouth.ma.us
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HCORPORATE�Nb39 Yarmouth Conservation Commission jjerolimo@yarmouth.ma.us
Administrative Review
Applicant Information:
Name: G-�, SM /iCle
Mailing Address: 446 9 W I l )
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Phone: (6( ) l J- 000 Email: L.Vr) GC f 0(0 l"GL, ('LT
I hereby authorize the individual members of the Yarmouth Conservation Commission and its agent(s)to enter upon the property listed
below for the purpose of gathering informationti regarding this Administrative Review form. /
Property/Location of otk: nl v"� ` I t` //O U ,t( /`7/� 02+66y
Street Name and Number
Signature:
Detailed Description and Reason for Proposed Work:
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Closest Distance to Resource Area: PeilA
Proposed Start Date: ‘'1 20 /'—
Company to do Work:
Name: (24
Address: (J L iO 0 ` I ,414—
Phone: 9 ( / (7 / Email: v (-- ✓7 '
Administrative Approval: Ca C(9.64 (-le w' ' `•,
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There is a$50 application fee,which can be paid by cash or chec made to"Town of Yarmouth".This approval is valid for
one year. This Approval does not grant any property rights or any exclusive privileges;it does not authorize any injury to
private property or invasion of property.
Yarmouth Conservation Commission• 1146 Route 28,South Yarmouth,MA 02664•(508)398-2231•Ext 1288
rev 9/2025