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TOWN OF YARMOUTH D
x 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451 ~`� ?019
Telephone (508) 398-2231 Ext. 1292 -Fax (508) 398-0836 Y'AMIVIUU I
OLD
J KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE—
APPLICATION
OMMITTED KIGSH�G�IWAY
APPLICATION FOR
CERTIFICATE OF EXEMPTION
de for the issuance of a Certificate of Exemption under Sections 6 and 7 of Chapter 470 of
jd, for the proposed work as described below and on plans, drawings, or photographs
lication.
Address of proposed work: 9 %1JC2 S% Map/Lot # 1-? 7 Z
Owner s): /,r/ r- ,Q - M4L,/L£CA0. Ca \-/ EC -L Phone #(77 V �S//- 3Z
All applications must be submitted by owner or accompanied by letter from owner approving submittal of application.
Mailing address: 9 i'/l) F/� 5'/ M/0;1wV/lQf ' /')� 4 Year built: 19d O
Email:/14JR�Gc t/£Al rl Preferred notification method: Phone 4-,- Email
rh A COVe-I\ c
Agent/Contractor: %I/O 'L-244-51-- /- /K Q ti51,72✓cl-j, +0 Phone eJ;F%8 �' Z -7 7
Mailing Address: 6-/ GOZ4A10 o0LY.X�'7-/ m/-1 p 2.3 Go
Email:(fOSG24t/£' /?1 r L I.14 £ C (' See &r MAI L.Ca nti Preferred notification method: Phone 1/ Email
Description of Proposed Work (Additional pages may be attached if necessary): Slr
Replace 11 windows with energy efficient Anderson white vinyl windows with grids. ; r
Replace cedar shingles with wood clapboard on front and back of house only. Color chip provided for clapboard and
front door -v h� r\ci
Signed (Owner or
Date:2-21 -)O1
➢ Owner/contractor/agent 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: 1:1?:
Amount ';�'b
Cash/CK #: 60
Rcvd by: %
Approved Approved with changes
Reason for denial:
ed
'--EB 2.2 2019 1 FEB I
TOWN CLERK IYARMUU 1 h
— 1.1nir1-'c wlrHWAY
Date Signed: 2-1 Signed: APPLICATION:! v FO n
V5.2017
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