HomeMy WebLinkAbout230306 Barnstable Conservation Executed PAAdopted Mar
Property o
Applicant’
Project st
Barnstabl
Applicant’
ACCESS
As the Ow
the Mas
General
designate
purpose o
(Notice o
possible,
either wee
understan
to inspect
I/we conf
Commiss
regarding
1. F
ap
2. F
of
pr
I have rea
________
Signature
________
Represen
rch 15, 2022, effec
owner’s name
’s (Represent
reet address_
e Assessor’s
’s Contact Ph
TO PROPER
wner(s) of the
sachusetts W
Ordinances
ed staff are a
of reviewing t
f Intent or R
notice will be
ekdays or we
nd that if attem
t the outside a
firm my/our
ioners, its ag
this applicati
rom the subm
pproval of the
rom the issua
f the project a
roject.
ad the above
___________
e of property
___________
ntative’s sign
ctive April 18, 202
P
e(s): _______
tative’s) Name
___________
Map & Parce
hone Number:
RTY PERMIS
e above refer
Wetlands Prot
(Chapter 23
authorized, a
the existing c
Request for D
e provided to t
eekends as ne
mpts to conta
areas of said
understandin
gent, and its
on for the pe
mission of the
e Notice of Int
ance of the O
and the final
e and I under
____________
y owner
____________
nature
C
Office: 508-
22.
Permission
___________
e(s)________
____________
el: Map___
:
SION
renced prope
tection Act (M
37), the Bar
as a matter o
conditions an
Determination
the applicant
ecessary for t
act me are un
property unde
ng the purpo
s designated
riod as descr
e Application
tent Request
Order(s) of Co
inspection by
rstand and a
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__
Tow
Conserv
Hyann
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to Access P
____________
___________
____________
_______
erty, I/we have
MGL Ch 131
rnstable Con
of law, to ente
d the propos
) to the Ba
prior to the v
the Commiss
nsuccessful, t
er this applica
ose of this
d staff, to en
ibed below:
(Notice of In
or Request fo
onditions (app
y the Conser
gree to allow
____
Date
____
Date
wn of Ba
vation C
230 South
nis Massach
E-mail: con
Property
___________
___________
___________
Parcel___
e been advis
1, Section 40
nservation C
er the outsid
sed work as d
arnstable Con
visit. Visits wil
sion and its ag
the Commiss
ation.
permission a
nter the outs
ntent or Requ
or Determinat
proval for No
rvation staff to
w inspection
___________
e signed
___________
e signed
arnstab
Commi
Street
husetts 0260
nservation@to
___________
____________
___________
_________
sed that unde
0) and the To
ommission,
e areas of th
described in
nservation Co
l occur during
gent to exam
sioner or its a
and I/we gra
side areas o
uest for Deter
tion; and
tice of Intent)
o confirm the
s as describ
________
________
ble
ission
01
own.barnstab
___________
___________
____________
er the provisio
own of Barns
its Agents o
he property fo
my/our applic
ommission. W
g daylight hou
ine said prop
agent may pro
ant permissi
of my/our pro
rmination) un
) to the comp
e completion
bed.
ble.ma.us
Form
_____
____
_____
ons of
stable
or its
or the
cation
Where
urs on
perty. I
oceed
on to
operty
ntil the
pletion
of the
m PA
Richard and Anne Segerson
Barbara Conolly
21 Cockachoisett Lane , Osterville, MA
116008
203-912-6421
03/06/2023
Anne segerson (Mar 6, 2023 17:47 EST)Mar 6, 2023
FORM-PA---Property-Access
Final Audit Report 2023-03-06
Created:2023-03-06
By:Barbara Conolly (barbara@gardensbybarbaraconolly.com)
Status:Signed
Transaction ID:CBJCHBCAABAApv_EWrf3jSAu1JAYLqBri-EoeTy7Aph7
"FORM-PA---Property-Access" History
Document created by Barbara Conolly (barbara@gardensbybarbaraconolly.com)
2023-03-06 - 8:59:06 PM GMT- IP address: 73.61.72.11
Document emailed to amullinsegs@yahoo.com for signature
2023-03-06 - 8:59:33 PM GMT
Email viewed by amullinsegs@yahoo.com
2023-03-06 - 9:02:28 PM GMT- IP address: 104.28.55.233
Signer amullinsegs@yahoo.com entered name at signing as Anne segerson
2023-03-06 - 10:47:12 PM GMT- IP address: 73.204.216.42
Document e-signed by Anne segerson (amullinsegs@yahoo.com)
Signature Date: 2023-03-06 - 10:47:14 PM GMT - Time Source: server- IP address: 73.204.216.42
Agreement completed.
2023-03-06 - 10:47:14 PM GMT