19-E0760 TOWN OF YARMOUTFIRECEIVEDII
�x 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4451AUG - 8 2019
Telephone (508) 398-2231 Ext. 1292—Fax (508) 398-0836
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W NG'S HIGHWAY HISTORIC DISTRICT COMMITTEB&S HIGHWAY
APPLICATION FOR
TDYA MpUCN MA CERTIFICATE OF EXEMPTION
SpUTH
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: v�0
Address of proposed work: I 'E L. v -k Map/Lot # M . 0 tkb �g: dool b
Owners): C"Ira\1 " %\' Phone#: `—A -Z(O2- z-Olab
All applications must be submitted by owner or accompanied by letter from owner approving submittal of application.
Mailing address: 5 L)orwelk MA � DZ -061 Yearbuilt: ►Q- S
Email: h Qs C7 t u tai rnS VAcorn Preferred notification method: Phone Email
Agent/Contractor:
Mailing Address:
Email:
Phone #:
Preferred notification method: Phone Email
Description of Proposed Work (Additional pages may be attached if necessary):
C�00-�' Y� ; aJ� e�C -e—
i��Signed (Owner or agent): Date: G r
➢ 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: 2"S-19
Amount a D
Cast GK 3b
Rcvd by: A
Approved
Approved with changes
Denied --
Date Signed: R ( Zdo Signed: r`
APPLICATION #: �9 t-'0 �%%
V5.2017
8/6/2019
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98 Starbuck Ln - Google Maps
Yarmouth, Massachusetts
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Street View - Aug 2014
RECEIVED
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AUG 15 2019
TOWN CLERK
SOUTH YARMOUTH, MA
Image capture: Aug 2014 ® 2019 Google
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8/6/2019
Google Maps
98 Starbuck Ln
98 Starbuck Ln - Google Maps
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RECEIVED
AUG 15 2019
TOWN CLERK
SOUTH YARMOUTH, MA
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