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APPLICATION FOR APPROVAL OF A SPECIAL PERMIT SUBDIVISION
This application must include Form C (Definitive Plan Application).
Please provide twelve (12) copies of the application along with ten (10) 11” x 17” sized plans and two (2)
24”x 36” sized plans for the Planning Board. Please also provide an electronic copy of the application
and plans in pdf format.
Date __________________ Application # ___________________
____ Cluster Residential Development _____ Major Residential Development
_____ Planned Residential Development _____ Planned Business Development or Row
Commercial
Name of Applicant Owner, if different
Address Address
Phone ________________________________ Phone ____________________________________
Email _____ Email ____________________________________
Location and description of Property
Assessor’s Map ______ Lot ______
Deed of property recorded in Barnstable County Registry Book Page ____
Or Land Court Certificate of Title No._____________________________________________________
Total acreage (combined) Current number of lots_________ Zoning District
Is proposal within the Groundwater Protection District? _________________
Percent of buildable uplands __________ Wetlands ____________
Required Frontage Lot Area Required
Brewster Planning Board
2198 Main Street
Brewster, MA 02631-1898
(508) 896-3701 x1133
brewplan@brewster-ma.gov
Date & Time Received
Town Clerk’s Office
Revised 05-2018 SP App- Subdivision Page 2 of 2
Plan #1 Title ___________________________________________________
Proposed number of lots______ Proposed number of dwellings_____
Total feet of proposed roadway____________
Location and description of property
Proposed Frontage Lot Area Proposed
Percent of Open Space provided___________________
What relief if any will be requested from The Town of Brewster Subdivision Rules and Regulations, Chapter 290
(describe)
Plan #2 Title ____________________________________________________
Proposed number of lots ______ Proposed number of dwellings _____
Total feet of proposed roadway
Location and description of property
Proposed Frontage Lot Area Proposed
Percent of Open Space provided___________________
What relief if any will be requested from The Town of Brewster Subdivision Rules and Regulations, Chapter 290
(describe)
__________________________________________
Signature of Owner or Authorized Representative
(If not Owner, please attach Agent Affidavit)