18-E016-A1 'e •� LR:_l_CF_IVEtr,
i Y 4 TOWN OF YARMOUTHG 212013
if' �' �� 1146 ROUTE 28,SOUTH YARMOUTH,MASSACHUSETTS 02664-4451NNIUU I H
o ;_' y G'S HIGHWAY
Y..,' m !.r Telephone(508)398-2231 Ext. 1292 Fax(508)398-0836
Ctiti:r".'i OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
AMENDMENT FORM
("MINOR CHANGE REQUEST")
A minor change request must be submitted within one year of the original approval date or while the work is still in
progress. Only a minor change may be approved by the Committee without the filing of a new application.
PLEASE TYPE OR PRINT LEGIBLY
Original Application#: 18-E016 Original Approval Date: 3/28/2018
Address of proposed work: /I 186 Cranberry Lane I '' '' ��t1 / ��L/
Owner(s): 13L h 1\-)ec�co% til&4 ester llei it .tit/Phone#: 663 -a3Y-33 /
Mailing address: 3 It% . fbttS IA • 1ki1D2a11VYn , b
JU 3Oig)
'
Email• ate-- i. 1 Ci. CD M Preferred notification method: Phone Email_US Mail
Agent/Contractor: t � (D �'{4-�m ri-fO Phone# da'
:sx37- 7 [/
�/
Email: MLah/1J' Jf Iat?e @1eDn1 e.IL$�,g...-4Preferred notification method: Phone X Email
Please describe proposed change(s)and attach plans/photos(as necessary):
9
I hCEIVEV
AUG 212018
TOWN CLERK
SOUTH YARmuuuu)I)H, MA
Signed(Owner or Agent) A - / ��� �i7 Date �/ �/
I/ Approved b .H Denied by OKH New C/A required? _Yes No
Reason for Denial: f 4 pP f`JED
Ii Mb 2 12018
YAKIVIUUTH
�c OLD KING'S HIGHWAY I
Signed OKH Chairman C�� Date 8/2/j2-°,7'
AMENDMENT# 18-E016-A1
1112015 •