HomeMy WebLinkAbout0126 THISTLE DRIVE - Health 126 Thistle Drive, Centerville _
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CF THE 1p� DATE:
FEE:
+ BARNSPABLE, *`
v i1639.KnSS� REC. BY ArEO PAp'�A`0
r t , Town of Barnstable SCHED. DATE: 9
�.� Board .of Health
67 Main Street, Hyannis MA 02601
Office: 5 90-6265 2 1999 N Susan G.Rask,R.S.
FAX: 50 790-6304 Tt![wop Sumner Kaufman,M.S.P.H.
HFALTM "� Ralph A.Murphy,M.D.
1
VARIANCE REQUEST FORM .
LOCATION41&-r/s
Property Address: 1,0 T fZ 0 oru VS
Assessor's Map and Parcel Number: I �-4-> Size of Lot: ZZ1 S
Wetlands Within 300 Ft. Yes Subdivision Name: `�I�l1�y�
No
Business Name:
APPLICANT &Pjbani
CONTACT PERSON
Name: Name:
Address: 7fv, li�,/,�dress:
Phone: Phone:
FAX: oleo I FAX:
VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed)
Checklist(to be completed by office staff-person receiving variance request application)
—Four(4)copies of plan submitted(including septic system plans and/or restaurant floor plans)
✓ Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting
date at applicant's expense(for Title V and/or local sewage regulation variances only)
Full menu submitted(for grease trap variances only)
Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/lessee only],outside
dining variance renewals[same owner/lessee only],and variances to repair failed sewage disposal systems[only if no expansion to the building proposed])
Variance request submitted at least 15 days prior to meeting date
VARIANCE APPROVED Susan G.Rask,R.S.,Chairman
NOT APPROVED Sumner Kaufman,M.S.P.H.
REASON FOR DISAPPROVAL Ralph A. Murphy,M.D.
Q:/WP/VARIREQ
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