HomeMy WebLinkAbout18-A070-A2Y TOWN OF YARMOUT RECEIVED
r a ;d: 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-445
"a SUN 2 4 2019
E', f Telephone (508) 398-2231 Ext. 1292 Fax (508) 398-0836
�� � OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEI YARNIOUTH
OLD KING'S HIGHWAY
4� 25 2019AMENDMENT 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 #: `d —140 -2 e) IOriginal Approval Date: 7 " p J g
Address of proposed work: —/7 V Ss n��e 5 �(?It 0,4'9
Owner(s):r 6 Phone #:
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Mailing address:
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Email: a 02 a Preferred notification method:—Phone— _US Mail
Agent/Contractor: Phone #:
Email:
Preferred notification method: Phone , Email
Signed (Owner or Agent)
Approved by OKH
Reason for Denial:
Denied by OKH New C/A required?
Date (a, dq, `/
Yes No
YARMOU I,
nLg � c-AiAt,+
Signed OKH Chairman Date
AMENDMENT #
11/2015
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