AP - 2022-016 Crocker 2110 Main St Barn FA SP r — — — — — — —
Town Clerk Stamp
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Town of Barnstable
Zoning Board of Appeals
Application for a Special Permit
For Office Use Only
Date Application Received: Appeal No.:
Hearing Due Date: Hearing Date:
Decision Due:
Property Owner: T>--actin C'xzc)v-, r✓`('- Phone:(G0'&) -6U2 I470
Property Location: s,A, s, vuoe` , I C A In S F'_e Village:
City: wr-C A V YI<S b`� State: m� I ZIp:OZ(OIOSi
Address of Owner
(if different from above): streetx.Street Name
City: State: I Zip:
Assessor's info: Ma 23� Parcel: Zoning District: '1F,V,p: O�� g '(Z.i- Groundwater Overlay:
Registry of Deeds/Land Book:2S4 Page: (fll Document#: Certificate#:
Court Reference: I Plan Book: Goo�— 622. Plan Page: fao x o c, S C (O'r(vA
Applicant's Name:' D�fAC, Uty-) Phong: SQ)'jO-Z 1L �
Applicant's Address: � �sQtNal(Y�� IY 1 ( v � C� t— Fax#:\
city: WcSA � rr,S'�r��e_ State: Mf) I Zip:026al
If Applicant(s) differs from owner, state nature of interestz
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The undersigned hereby applies to the Zoning Board of Appeals for a Special Permit, in the manner and for the reasons set
forth below:
Cite Section(s) &Title(s) from Zoning Ordinance: 1240- y l v
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Description of Activity/Reason for Request: armrh odmeunpl�nzel if n�resrrin�
1�v �Jra•v�de �evv-no_rie'nt- havS��nc� �t� � t�ovcn�5
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Is property subject to an existing Special RYES- Please list Appeal#(s): 2 d I S— O03 ID NO
Permit or Variance: I I
t The Applicant(s)Name will be the entity to whom the Special Permit will be issued to.
z If the Applicant(s)differs from property owner,the Applicant wil l be required to submit one original notarized letter from the owner authorizing the Applicant(s)to represent them
before the Board. Also,if perspective owner(s),an executed Purchase and Sales Agreement or lease,or other documents to prove standing.nd interest in the property will be required.
Existing Level of Development of Property-Existing Number of Buildings: I
Existing Use of Property: tpoo`7
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Existing Gross Floor Ar@a: Cj 1 .iC T)le�..f �j
I 1�(rbloClP C ,s co SS/ tn�SC `���T��i,-,ar�—Z I
Proposed Level of Development of Property-Tgtal Numbel of Buildings:
Proposed Use of Property: Kes )
Proposed New Gross Floor Area: C�t� C�✓ — ('��
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ISite Plan Review Number: Not required forsmgleorTwo-Family use I Date Approved: _
Description of Constructj`ogpActivity(if applicable): SQF,��j(
�� OtCe��CNI "�� C�_XIS�iVI �j OtC (Y2��aP� VnTl,C�1'l�(
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Is the property located in a designated Historic District: y No
Is the building a designated Historic mark: Yes gib
Is this proposal subject to approval by the Board of Health: Yes 0
Is this proposal subject to thejurisdictionof the Conservation Commission: Yes I$f¢
Have you applied for a building permit: Yes f'Q
Have you been refused a building permit: Yes Yj�6
Signature: �,,, Fer„e, Date: 3 129 1 ZOZZ
Print Na Phone( (Oz -Z 1y�
Mailing Address:
City: Wes gGIY (lSlwrJ1� State: Izip: cx2(0(oU
Fax Number: Email Address: 6C-QCO" CZ �-Y)GLtSh Pe2CCxnrmn� C'SLt1'�