HomeMy WebLinkAbout18-E037-A10F.1 TOWN OF YARMOUTH,RFCF1V,ED
y 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-4451
H ATTA „ 5 Telephone (508) 398-2231 Ext. 1292 Fax (508) 398-0836 SEP � 20.9
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTE YANIVIUU I h
OLD KING'S HIGHWAY
AMENDMENTFORM
("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 #: I S_ - IF -0 3 '7 Original Approval Date: :s-- S- -1 k
Address of proposed work:
Owner(s): 7/SDf�" CTS/'�="'� Phone #: /Z SY�-'
Mailing address: l GG"�ir, /�t�Si�s. ,���� J.rr,�h�r/%G� D�� i /�i'� 2G7_r`
Email: . �ryl--ice fh �i1'��ii/ -��'! Preferred notification method:—Phone ail _US Mail
Agent/Contractor: /7 o'� Phone #:
Email: 4�� Preferred notification method: Phone `-" Email
Please describe proposed change(s) and attach plans/photos (as necessary):
� Cllri�t' S'T�-Y CLCG�+�S 4V h 4�7fzpev-. fin e
e!) JA—of:
Signed (Owner or Agent)
Date
SEP -4 Zoic
TOWIN ,"L ERK
SOUTH YARMOUTH, MA
v Approved by OKH Denied by OKH New C/A required? Yes No
Reason for Denial:
SFP r
YAKMU 1
Signed OKH Chairman -� OLD KING'S I-iIG,1`i`JAY
"_"date % rf 2 V
AMENDMENT # `�--ID3_? -4 )
11/2015
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OLD KING'S HIGHWAY
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RECEIVED 4,
SEP -4101
TOWN CLERK ROVE
SOUTH YARMOUTH, MMAD
SEP ED
YARMOUTH
OLD KING'S HIGHWAY