4919 583A Forest Rd ApplicationTOWN OF YARMOUTH '21SE P4: y9 RED:
BOARD OF APPEALS
APPLICATION FOR HEARING
Appeal#: L4q l q Hearing Date: ID I JH Fee$
Owner -Applicant: "&v ?0% i � Q0 el —all D 1,4,0lr
(/ (Full Names- including "/a)
19 .r 'v� �- ,s� . sow`' � ,"o h� MA , Al 77 y - f4'3- y6o l vto(, f eapecod if,4,t5 R
(Address) (Telephone Number) (Email Address) ro com
and is the (check one) D Owner K Tenant Prospective Buyer I Other Interested Party
Property: T 7 is application relates to the property located at: p AH i � 4tms
and shown on the Assessor's Map #: as Parcel#: 10 M'�
Zoning District: ig 33 If property is on an un-constructed (paper) street name of nearest cross
street, or other identifying location:
Project: The applicant seeks permission to undertake the following construction/use/activity
(give a brief description of the project. i.e.: "add a 10' by 15' deck to the front of our house" or
"change the use of the existing building on the property"):
RELIEF REQUESTED: The applicant seeks the following relief from the Board of Appeals:
I
c g (te h -ot
1) REVERSE THE DECISION OF THE BUILDING INSPECTOR OR THE ZONING
ADMINISTRATOR dated attach a copy of the decision appealed from). State the reason
for reversal and the ruling which you request the Board to make.
2} f/ SPECIAL PERMIT under §�0 - 2 of the Yarmouth Zoning By-law and/or for
a use authorized upon Special Permit in the "Use Regulation Schedule" §202.5 F-ff
space below if needed)
3) VARIANCE from the Yarmouth Zoning By-law. Specify all sections of the by-law from
which relief is requested, and, as to each section, specify the relief sought:
Section:
Relief sought:
Section:
Relief sought:
Section:
Relief sought:
ADDITIONAL INFORMATION: Please use the space below to provide any additional
information which you feel should be included in your application:
FACTSHEET
Current Owner of Property as listed on the deed (if other than applicant):
Name & Address-
Title deed reference: Book & Page# or Certificate #_
Land Court Lot # Plan # RrOdeco of recent deed
Use Classification: Existing:
Proposed:
Is the property vacant:
If so, how long?:
§202.5 #
202.5 #
Lot Information Size/Area: Plan Book and Page / Lot#
Is this property within the Aquifer Protection Overlay District? Yes � No
Have you completed a formal commercial site plan review (if needed)? Yes No- Z
Other Department(s) Reviewing Project: Indicate the other Town Departments which are/
have/ or will review this project, and indicate the status of their review process:
Repetitive Petition: Is this a re -application: J Q If yes, do you have Planning Board
Approval? _
Prior Relief: If the property in question has been the subject of prior application to the Board of
Appeals or Zoning Administrator, indicate the date and Appeal number(s) and other available
information. Include a copy of the decision(s) with this application:
Building Commissioner Comments:
Applicant s /Attorney/Agent Signature
k
wner's Signature
Address: � 1 0- t- ryP V )-r
t 66- Aivo AA M14
Phone
E-Mail:_`��R�i y,,p 'M d or�
z 7 22 /
Building Commis one ignature Date