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HomeMy WebLinkAboutApp# 18-E114 • , 0 _tii.° 1TOWN OF YARMOUTH ti e te,' s 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451 C��� RECEIV a Telephone(508)398-2231 Ext. 1292-Fax (508)398-0836 OCT 7 • 18.08 OLD KING'S HIGHWAY HISTORIC DISTRICT COMMIyHk/1e OCT 232018 ��u. skGNWgY APPLICATION FOR SOUL TOWN CLERK MA CERTIFICATE OF EXEMPTION Application is hereby made for the issuance of a Certificate of Exemption under Sections 6 and 7 of Chapter 470 of Acts of 1973, as amended, for the proposed work as described below and on plans, drawings, or photographs accompanying this application. Type or print legibly: Address of proposed work: I G e00Gi B ( Ten Map/Lot# /57/Z/ Owner(s): - ] V; L / 5 I Phone#:64t 671 2 All applications must be submitted by owner or accompanied by letter from owner approving submittal of application. Mailing address: 9 C/aSCI/4 ie.P \ / f/_-$ /i. Year built: / 9 7 gEmail: 5 L.tS i i e7 0 Aace, .Cc44A Preferred notification method: Phone0c Email Agent/Contractor: (��� \+C�Q ((< Phone#: COB 39q/ 70 5 Mailing Address: v7 C4 AA?=a,-( Lx/ S ,2/td C -t14' ' a '- Email: CY p `( am /15P� /Ctii OAST. preferred notification method: Phone Email Description of Proposed Work(Additional pages may be attached if necessary): C ("6.1 /crs /204 Qo (off TO LAAfO/l44Z44. C 1-k&cAL 3 bAcK 13� dcl ��-r t 2,'4,L Pc)0-44 4 s t 1� 3 Cry zs ( � T SII Do =� L�Avy /29 -5 4fib t2Ciri cS col n T-0 5 l tit(Jr- I Signed(Owner or agent . u Date: /0i7 /g- > > Owner/contractor is aware that a permit may be required from the Building Department.(Check other departments,also.) > This certificate Is good for one year from approval date or upon date of expiration of Building Permit,whichever date shall be later. For Committee use only: Date: /07 gr. C' Approved _Approved with changes AP ®d,E® Amount 00 i Reason for denial: case. yk7& OCT 2 2 7018 Rcvd by: idry YARMOUTH /^/ —} OLD KING'S HIGHWAY Date Signed: Signed: V ' I .-() 41111n APPLICATION#: /S-'n/y V5.2017 • y From:Steve List<stlist67@yahoo.com> REE, �/E® Sent:Thursday,October 18,2018 1:05 PM OCT 1 8 To:Troy Walls<troy.walls@comcast.net>;Troy Walls<troy02664@gmail.com> 2018 Cc:Steve List<stlist67@yahoo.com> YARMOUTH Subject:11 George Bray Road OLD KING'S HIGHw , To Whom it May Concern, Please be advised that Troy Walls of Walls Construction is my Authorized Agent to work on my behalf at the property located at 11 George Bray Road, Yarmouth Port, MA 02675. Sincerely, Steven D. List Owner APPROVED OCT 222018 YARMOUTH OLD KING'S HIGHWAY RECEIVED OCT 2 3 2018 TOWN CLERK SOUTH YARMOUTH, MA - eVED . , Y '-' • " ..:....,..:1... • . . L,,,...,7 . , .. . 171(5. HI/1/4 y •..Ai .: , . . 4----_ •:-.H". . .' 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