HomeMy WebLinkAbout0803 MAIN STREET (OST.) - Health (2) 805 Main. Street
Osterville
— A= 117 052
f
�;-'K•i�;^'^>•r. Woo,"
e++.%'rQt•'-,-(-.-sJr....
TOWN OF BARNSTABLE leNew Application
, ,SIAB>� ; LICENSE APPLICATION �❑ Renewal
9� , . ,�g 200 Main Street 9.t A Hyannis,MA 02601 ❑ Transfer
508-862-4674 ❑ Other
NO BUSINESS MAY OPERATE WITHOUT A VALID LICENSE ON THE PREMISES 4
Name of applicant/corporation: ' _ (� !�
p9(� �1_
�. `� P ti.�.:i\.��._�,....___.._....__..._..._._._..__. Home hone#:
_ { -
Address of applicant/corporation:
- -
-.-u^'� --- .---- _ _.._........._...._............._......_..........._. Business #
p.__.__..._.....__.
.... _. .. -1?•..n—\l.��G.\mot t '\/�....__� 1_e.�_ �_�..._]. -__----.._....--._............._....................................._...__..._:._.._....------....._-.........
--'--
D/B/A U�-' -'---- Business phone#:
Business location: .- --
Business mailing address: _.__........._.... ._......� ......_.__......._......._......_..._............... -
Local business address: "
..............._.............._........_...._..._.. '
. ".. ...............
........._........................_............._....._..._...._._..._._._..................:......__....._...._............_.:_......_..........._..........__......._............_._.._............_:.._.._...._............._...__.._.-_.._...._.....__._...._............._...._._........._......_
Localmailing address: __._._.._.....- .:........_.... '-.......'--'--'--....--._._..._......_........_._.__..__....... -..._..............................__....-._...._........................-'-' -------'-......-....._......_........................_.....................--'---...._..............._...--..............
_._......_..__..._
LICENSE TYPE:
. a. ......... Annual Seasonal
:�.��.e.�....�•.,,.�..e.Q� ,:,-�._.................................
HOURS OF OPERATION: ._._......_V_as�.�►_. ._._..__....__._ FID#: -{'1 _....____...__..._.._......_
Name of manager: email:
9 --_ � � _...._��� �.._� ._ _._..._..._..._......_......._._.__.-.-._._..
Local mailingaddress: ............... \r `' � ....... _?s,:�.n....� �4r '.<�?a���.......;�.... !� �`��rn..........5.................................
Manager's Permanent mailing address: �..p_,` yX_._\_\_1' ._.....�_:..._ ._ � .. .����_L .. _...._ `'a_.. ....._......._......__..._.
Manager's home phone#:6n_ 96.Q q Business phone#: . ._ � _
Nameof property owner: .'' _............. ......._ ..... _ _ _......-._...._....._............ -- ---'-'-'-._._..__._._...._......._...._._._._
! ... .. ......_. ...... ... .
ASSESSOR'S MAP/PARCEL#: MAP _. _.f._ .................. PARCEL
...n
...........................
List any flammable substance or hazardous waste used in business(specify):
Applicants must contact the Building Commissioners office, (508) 862-4038,
the Board of Health office, (508) 862-4644, and the appropriate Fire District ,
office to schedule inspections.
Signature of applicant
. �
..................................................................... -...........................
Eor Town use onlly f�REAL ESTATE TAXES PAID IN FULL' C ..0 i�l.�1/Y.(.Q •Yt - I ,c.. /
PAYMENT AGREEMENT IN EFFECT.ON
IS THIS USE PERMITTED WITHIN THIS ZONING DISTRICT? YES NO
INSPECTORS APPROVAL Capacity set by Building Division..............._.......................
Building/Zoning............_..__........._........................................._..................................._... Date .............................................................................. Board of Health............_......._.......::.....:....._.................._,...:............................. :._ Date{....................................._......._..................._.........
f
Wire ............................-..................................._.......... Date ................................................................... Plumbing ......................................................................................`._.......Date ..............._...................................................._......
Gas ......__.................................................................. Date ............................................................................. Fire District ...._........................................................................._... Date ..._...................._........._...._..............................
Comments:-------...._..._..:.............._.............................._.................._....._...._........._.................................................................._._.................._..._...................:...................................................__..................._.._.........................................._......._......_...._...._.................._..............-..-_...........................__......_..........._.
White-Licensing Authority Canary-Health Division Gold-Building Commission Pink-Fire Department