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(-\
Application for a Permit to Build .
Fee must accompany this application
Yarmouth .ZilLy ve
7-tr-0
TO THE BOARD OF SELECTMEN
The undersigned hereby applies for a permit to build, according to the following specifications:
L Name of Owner -Mg i;hkr .s, Address n soAtitpt
2. Name of Architect (if any) 4/4i
3. Name of Builder 1.41/4i/M14.‘ .10/4;04
4. Precinct No. # 02. Lot No. - 11,30- Plan: Name or No.
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5. Name of StretA S 9a/jett -:••• 70/204,04,9xlizr,
6. Purpose of Building shoal dais": coxiast cal anti, + 40445u4 Crots:r Door,
7. Material bo#P fia42/444-e4/091/4-rwv — tic ri-PC•t Anil& 4/40 p'my
8. Estimated cost of building 15 4,er, .. • !
9. Dwelling S/Ikoallo Men/4/
10. Cottage —
11. Heat
it/ht j
12 Basement
13. Garage
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14. Store
15. Shop dy,
16. No. of stories S//416-4 No
17. Is there to be a Store in the lower storey $9,
18. Size of Lot. No. of feet front No. of feet rear No. a feet deep
19. Size of building. No. of feet front .No. of feet side No. of feet rear
20. Distance from nearest building; .Front ft.; side ft.; side ft.; rear
21. Distance back from line or street from rear lot line side line
Show by diagram the location of propsed building with relation to distances from adjoining lots, on reverse side.
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Address...a ase rikkaacipc,
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Itreet Name ...././IMy t`nW e SCI
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S ' Left Side Depth of Lot
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j Right Side Depth of Lot . -
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ZStreet Name ...._
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1. 1740 Aap
BUILDING PERMIT REVIEW
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APPLICANT: pas . k- twLL% Ifauw F I BLDG PERMIT NO:
LOCATION OF PROPERTY: DATE FILED: ,t,. :lj :IRA
THE FOLLOWING CHECK-OFF SHEET IS DESIGNED TO CLARIFY THE PROCEDURES AN INDIVIDUAL MUST
FOLLOW IN ORDER TO OBTAIN A PERMIT TO BUILD OR ALTER A BUILDING. THE BUILDING DEPARTMENT
WILL CHECK ON THE FOLLOWING: (A) CONSERVANCY DISTRICTS (B) HISTORICAL DISTRICTS (C) FLOOD
PLAINS ZONING, AND WILL BE RESPONSIBLE FOR ASSISTING_THE APPLICANT THROUGH THE FOLLOWING
AGENCIES. /
RESIDENTIAL BUILDING:
A) CHECK WITH THE HEALTH DEPARTMENT IN REFERENCE TO SEPTIC SYSTEMS FOR SEWAGEDISPOSAL. _----__---
B)--CHECK WITH CONSERVATION COMMITTEE IF THE LOT BORDERS ON ANY TYPE OF WETLANDS.
EXAMPLES: STREAMS, PONDS, RIVERS, OCEAN, BAY, BOGS, MARSH, ETC.
C) CHECK WITH PLANNING BOARD FOR LOT RELEASE.
J ,
COMMERCIAL BUILDING:
A) ENGINEERING DEPARTMENT-FOR PARKING AND DRAINAGE REQUIREMENTS, TOPOGRAPHY SITE PLAN
REVIEW.
B) CONSERVATION CO1IMITTEE-IF LOT BORDERS ANY TYPD OF WETLANDS.
C) PLANNING BOARD- TO SEE IF LOT COMPLIES WITH ZONING BY-LAWS.
D) BOARD OF HEALTH-FOR SEWAGE DISPOSAL REQUIREMENTS, HEALTH RELATED ACTIVITIES. -
EXAMPLES: SAUNA BATHS,-SWIMMING-FOOLS, RESTAURANTS, ETC.
E) FIRE DEPARTMENT FOR PROPERTY PROTECTION, PERSONAL SAFETY, (SPRINKLERS, SMOKE
DETECTORS).
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REV BY: /
ENG G DEPARTMENT: YES Y DOES NOT APPLY SIGNATURE , 2� _ DATE 7 /7/4
CONS VTION COMMITTEE: YES DOES:NOT'APPLY SIGNATURE 'C DATE /7 le
PLANN G BOARD: YESDOES NOT APPLY SIGNATURE ' DATE
__ - . SIGNATURE- - A66.6414114( //?42
BO OF HEALTH YESES NOT APPLY_SDATE;74)42
FIRE DEPARTMENT: YES DOES NOT APPLY SIGNATURE DATE
COMMENTS: %
larif lin.;
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Application to ..:-/—/
`SOld Kings Highway Regional Historic District Committee
in the Town of Yarmouth for a
CERTIFICATE OF APPROPRIATENESS •
Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470,
Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs
accompanying this application for:
CHECK CATEGORIES THAT APPLY•
1. Exterior Building Construction: 0 New Building 0 Addition fl Alteration ,
Indicate type of building:. 0 House al Garage ❑ Commercial 0 Other •
2. Exterior Painting: 0 • __ �+
3. Signs or Billboards: ❑ New sign ❑ Existing sign_ ❑ Repainting existing sign _--—�� _ f
4. Structure: Fence Wall _-- ❑ Flagpole 0 Other
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(Please read other side for explanation and requirement). - .
TYPE OR PRINT LEGIBLY DATE 41 aol ro
ADDRESS OF PROPOSED WORK a0 5G1.iNNA/ fur-' --,1ti.:,+'tt:<n ASSESSORS MAP NO.
`/ s. • hint
7 C'
OWNER 1bi,^'t•7V 1GGnrp - ASSESSORS LOT NO.
I
HOME ADDRESS 5 t:WE TEL- NO. 3S. ' SciIOC)
FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public,.
street or way. (Attach additionaltisheet if necessary).
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.t An/ fikelarsilGS si - -- /10, 16.1 -----
lJnw PEii `l0 ai�,ly>Le/ ►?tip
AGENT OR CONTRACTOR A, t ` ?"1/-1, l_L / Irl--U TEL. NO. ?Crt , c38 -74'
ADDRESS 16 t mn/R -Rd yA_RtiY �6R ' M
WA
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DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars'of work to be done(see No. 8,other side),including
materials to be used, if specifications do not accompany plans. In the case of signs,give locations of existing signs and proposed
locations of new signs. (Attach additional sheet,if}}necessary).
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Signed r*- � .
Owner-Contractor-Agent
Space below line for Committee use.
Received by H.D.C. . •
Dat "--C17.4
/4The C/ 'ficate is hereby - �� Z Date ', L.)
Time .-t 1,S 79. /F/,
_
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Approved . — IMPORTANT: If Certificate is approved, approval is subject to the,2O day appeal period
provided in the Act. /b/)
Disapproved ❑ Please return to: Yarmouth Historic District Committee (
P.O. Box 124,Yarmouth Port,Mass.02675
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ADDITIONAL INFORMATION FOR MAKING AND FILING AN APPLICATION
FOR A CERTIFICATE OF APPROPRIATENESS
The four categories for which a Certificate of Appropriateness is required are: (application for demolition or removal is a
separate form).
1. EXTERIOR BUILDING CONSTRUCTION (new or existing buildings): An application is required for any exterior of a
building to be erected or altered including windows, doors, siding, roof, light etc., that will be visible from any public street,
way or public place. The following scale drawings are required in duplicate with application: plot plan (if addition -show
existing buildings in outline), floor plan and elevations. Also required are snap shots of existing buildings, where additions or
alterations are to be made. No plot plan is required for addition or alteration which does not touch the ground.
2. EXTERIOR PAINTING: An application is required for any portion of a building, structure or sign to be painted that is
' visible from a public street, way or public place. Color samples must be attached to these applications. An application is not
required when re afnting existing colors, changing to white,or using colors approved by the Town Historic District Committee.
3. SIGNS OR BILLBOARDS: An application is required for any sign or billboard to be-el:Feted within the District, with the
following exceptions:
a. Existing signs or billboards on November 27, 1974 shall have until November 27, 1977 to secure an approved Certificate
of Appropriateness.
b. Temporary signs for use in connection with any official celebration or parade or any charitable drive as long as they are
removed within three days of the event. Certain other temporary signs that the Committee feels does not detract from
the Act may be allowed with the prior permission of the Committee.
c. Real Estate signs of not more than 3 square feet in area advertising the sale or rental of the premises on which they are
erected or displayed.
d. A single sign of not more than 1 square foot in area showing the name, occupation or address of the occupant of the
premises on which they are erected or displayed in a residential zone.
4. STRUCTURE: An application is required to build or alter any structure within the District which is defined by the Act as a
combination of materials other than a building, sign or billboard, but including stone walls,flagpoles,hedges, gates, fences, etc.
GENERAL REQUIREMENTS
5. Work on projects requiring approval shall not be started until the Certificate of Appropriateness has been filed with the Town
Clerk by the Committee. Approval is subject to the 20 day appeal period provided in the Act.
6. No changes shall be made from the original approved specifications without advance approval of the Commission on an
amended application filed with the Committee.
7. A separate application must be filed with each project requiring a Certificate of Appropriateness. •
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8. Under heading of "Detailed Description of Proposed Work" give detailed data on such architectural features as: foundation,
chimney, siding, roofing, roof pitch, sash and doors, window and door frames, trim, gutters —leaders, roofing and paint color.
9. Unless application is complete and legible and all material required is supplied, application will not be accepted or acted upon.
Copies of the Act establishing the Regional Historic District may be obtained at the Town Hall.
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1 Application to
el (110�e�+". .1
al el"or 411r:. �?
Old King's Highway Regional Historic District Committee
J1� 1 in the Town of Yarmouth for a
CERTIFICATION OF EXEMPTION
• Application is hereby made, in triplicate,for the issuance of a certificate of exemption undr.: Section 6'and 7 of Chapter 470,
Acts and Resolves,ot Mcssachusetts, 1973, as amended for proposed work as described below and on plans,drawings,or photo-
graphs accompanying this application.
TYPE OR PRINT LEGIBLY p .(' DATE
ADDRESS OF PROPOSED WORK ao vQ u/SPF L /�(/i� ASSESSORS MAP NO.
OWNER :vier-. EN,e C/ /re:47-6-: ASSESSORS LOT NO.
HOME ADDRESS .• ' SOLI/PA: g 6 Ir �tTEL.NO.
` ,y n � dit [ �cAV1
AGENT OR CONTRACTOR �r � t. r �,D QQl-X:7):41-/ •
ADDRESS J'n eekeel yr;,AINflIT(�� Vtw
(2 ,J (W n TEL NO. 111- IR ly
This application is for exemption of proposed exterior construction on the ground that:
❑ (1) It will not be visible from any way or public place.
�. (2) It is within a category declared entitled to exemption by Old King's Highway Regional Historic District Commission.
(Check applicable box)
i _ PROPOSED WORK: Describe and furnish plan of proposed work,showing location on lot,and, if an addition is involved,show-
ing location of existing building. I
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SIGNED `O�Q v— /1CtJ c,C.
Space below line for Committee use.
Owner-Contractor-Agen�
Received by H.D.C. The Certi -cate is hereby in� re—/ .7 P ' ✓ A
Date „✓den 4, , 'ifs a , I
41,
CI e�
Time _ /� 6 — - _ ,4/ A .—
By Date
w
--- Approved 0 -- -- - "' • — — - The categories of work entitled to exemption re alisted on— k
Disapproved 0 the back of this form.
EXTERIOR ARCHITECTURAL FEATURES
SUITABLE FOR CERTIFICATES OF EXEMPTION
FOR RESIDENTIAL USE ONLY
0 -
FENCES: 1. Post and rail, split,half round or round;natural finish
2. Square rail;white or natural finish •
3. Stockade;natural or gray stain finish;not forward of face of main building
4. 'Picket;white only
(Maximum height of all fences,4 feet)
HEDGES: natural, not to exceed four feet in height
DECKS: constructed of wood,on single family dwellings, built after 1900,at first floor level,at the rear only,
railings not to exceed 30 inches in height, not over 50%to be visible from a way;natural finish or color
compatible with building involved
BREEZEWAYS: enclosure of existing breezeways,consistent with style,material and color of house,excluding sliding
glass doors facing street,way or public place
FLAGPOLES: on residential property, not over 24 feet high,not less than 20 feet from way,constructed of wood, with
natural finish or painted white,or of aluminum,or of fiberglas or metal painted white
ARBORS AND TRELLISES: of lightweight,wooden construction, not over nine feet high •
ROOFS: natural cedar shingles,or asphalt shingles per approved color samples;not over five inches exposure to
weather
SIDING: natural cedar shingles,or wooden clapboards•natural or approved color;not over five inches exposure
to weather
STORM SASH,STORM DOORS,WINDOW SCREENS, SCREEN DOORS,GUTTERS AND LEADERS: permissible if
consistent with style,material and color of building
LIGHT POST: permissible if consistent with style,material and color of building
AIR CONDITIONERS: portable,window units at side or rear of building
STONE WALLS: construction of field or split stone, not exceeding 30 inches in height
NOTE
1. All prior bulletins hereby superseded.
2. Conditions contained in certificates of appropriateness shall be binding regardless of any exemptions contained herein.
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